Clinical spectrum and outcome of invasive filamentous fungal infections in children with Type 1 diabetes: North Indian experience

DOI Web Site 参考文献17件
  • Dayal Devi
    Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Jain Puneet
    Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Kumar Rakesh
    Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Bakshi Jaimanti
    Department of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Menon Prema
    Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Das Ashim
    Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Singhi Sunit
    Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Singh Meenu
    Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

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There is scarcity of data on spectrum and outcome of invasive filamentous fungal infections (IFIs) in children with Type 1 diabetes (T1D) from developing countries. A retrospective review of medical records of children with T1D hospitalized with IFI over the past decade at the Pediatric Endocrinology and Diabetes Unit of a large tertiary care hospital of North India was performed with an aim to study their clinical spectrum, hospital course and final outcome. Of the 10 patients studied, nasal/paranasal involvement was seen in 6 and pulmonary involvement in 5 patients. One patient developed disseminated disease. Majority of the identified mycoses belonged to Class Zygomycetes Order Mucorales. Early surgery along with antifungal therapy helped limit the extension of infection and achieve a good outcome in majority of patients. Two patients died; one with a late diagnosis of pulmonary mucormycosis and the other with disseminated disease. The longterm morbidity in the survivors was minimal. In conclusion, rapid diagnosis followed by a multimodal approach involving aggressive surgical debridement, appropriate antifungal therapy and control of hyperglycemic state is the key to good outcome in this otherwise lethal infection.

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