Demographic and Clinical Characteristics
The study included 34 pediatric patients with a median age of 10 years
(range, 3-17 years), and a female to male ratio of 1:1. The demographic
and clinical characteristics of the study cohort are shown inTable 1. ALL and AML accounted for the majority of all
underlying diseases (56% and 24%, respectively). Twenty-two patients
(65%) met high-risk criteria for fungal infection and were given
prophylactic itraconazole or fluconazole prior to the diagnosis of AIFR.
Most of the patients developed AIFR during disease remission (23
patients, 68%). In patients post-BMT AIFR was first diagnosed within a
median of 112 days post transplantation (range, 6-1203 days). Ten
patients (29%) developed AIFR within 6 months of BMT. Thirty-one
patients (91%) were severely neutropenic (absolute neutrophil count
<500/mm3) at the time of diagnosis of acute
infection; the mean duration of neutropenia was 17 ± 14 days (median, 13
days; range, 1-68 days). Fever was the most common presenting symptom of
AIFR, in 29 children (85%), followed by facial swelling in eleven
(32%). Orbital complications included proptosis (n=4, 12%),
periorbital edema (n=3, 9%) and oculomotor nerve palsy (n=3, 9%).