RESUMO
Yeast infections cause morbidity in children with cancer and we evaluated species distribution and antifungal susceptibilities of the etiologic agents in this group. Specimens from 58 children yielded 64 cultures positive for yeasts. Central venous catheters were present in 56 (97%) of the children and neutrophil counts were <500 cells/ml3 in 34% of the patients. Twenty-two (38%) had received recent antifungal treatment, with 15 (25%) receiving fluconazole (FLU) prophylaxis. The Candida isolates recovered from four (27%) of the children on FLU prophylaxis, were resistant to this drug. Candida albicans isolates were susceptible to 100% of antifungals tested, whereas non-C. albicans Candida spp. were variable in their susceptibility patterns. FLU prophylaxis minimally affected susceptibility.
Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Farmacorresistência Fúngica , Neoplasias/complicações , Adolescente , Adulto , Candida/isolamento & purificação , Candidíase/tratamento farmacológico , Candidíase/etiologia , Cateterismo Venoso Central , Criança , Pré-Escolar , Estudos de Coortes , Fluconazol/farmacologia , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Testes de Sensibilidade Microbiana , Neutropenia/microbiologia , Infecções Oportunistas/tratamento farmacológico , Infecções Oportunistas/etiologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
A four and one-half year-old child presented with a several month history of shoulder pain. Her workup revealed a large, homogeneous tumor in the apex of the chest. Surgical resection was performed demonstrating ganglioneuroblastoma. This case illustrates an unusual cause of joint discomfort in children.
Assuntos
Ganglioneuroblastoma/diagnóstico , Ganglioneuroblastoma/cirurgia , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/cirurgia , Dor de Ombro/etiologia , Pré-Escolar , Feminino , Ganglioneuroblastoma/complicações , Ganglioneuroblastoma/patologia , Humanos , Imageamento por Ressonância Magnética , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/patologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Fc gamma receptors, and in particular genetic variation in these receptors, are important in disorders of hose defense, immunohematologic disease, and systemic autoimmune diseases. We investigated the His-Arg (CAT/CGT) polymorphism at codon 131 of the Fc gamma receptor IIA gene, which influences ligand binding by the receptor. Previously, individuals had been classified phenotypically on the basis of differential binding of murine immunoglobulin G1, but the Fc gamma receptor IIA genotype distribution has not been reported. We used selective PCR-based sequence analysis of genomic DNA to determine the distribution in healthy individuals. For African-Americans, the genotype distribution was determined to be A/A (14%), A/G (60%), and G/G (26%); for Caucasian Americans, the distribution was A/A (30%), A/G (51%), and G/G (19%). These data correlate well with phenotypic data. We implemented a nonradioactive single-stranded conformational polymorphism analysis to rapidly identify all three genotypes. The PCR-single-stranded conformational polymorphism analysis method will facilitate studies of the genotype distribution in individuals with disorders of immune function.
