Leukemia Combined with Hepatosplenic Abscesses in 19 Children
- VernacularTitle:儿童白血病并肝脾脓肿19例
- Author:
yan, SU
;
min-yuan, WU
- Publication Type:Journal Article
- Keywords:
leukemia;
hepatosplenic abscesses;
child
- From:Journal of Applied Clinical Pediatrics
1993;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To improve the probability of early diagnosis and treatment on leukemia combined with hepatosplenic abscesses and to reduce the mortality of leukemia in relation to infection.Methods Nineteen children,who were diagnosed and treated as leukemia combined with hepatosplenic abscesses in Hematology Center of Beijing Children′s Hospital from Jan.2000 and Dec.2007,were selected.Data of them including presenting signs and symptoms,proof of diagnosis,culture data,treatment modality,opportunity of recovering chemotherapy,following up data and so on were reviewed.Results The neutrophil counts were more than 1.0?109 L-1 in all children when hepatosplenic abscesses were diagnosed by means of images.Positive blood cultures were found in 7 children and positive pharyngeal or stool cultures were found in 8 children.Sonographic-guided hepatic abscess biopsies were operated in 3 children,but microbiologic and histologic examination were negative.According to the positive cultures or the validity of empirical antimicrobial or antifungal therapy,7 cases of fungal,7 cases of bacterial and 5 cases of bacterial/anaerobic hepatosplenic abscesses were diagnosed.During follow-up period from 10 days to 2 years and 11 months(median time was 9 months),images improved in 17 children,abscesses disappeared in 10 children and chemotherapy restarted in 84% children.Conclusions The images should be taken opportunely when neutropenia recovered in neutropenic patients with prolonged fever.As blood cultures were often negative,the clinician must pay more attention to the other positive cultures involvement.Early biopsy is advised in order to obtain positive results.The prognosis of bacterial/anaerobic hepatosplenic abscesses is good by adopting an extended spectrum antimicrobial treatment.Antifungal therapy must last enough time in children with fungal hepatosplenic abscesses.Chemotherapy was advised when manifestations of hepatosplenic abscesses improved significantly,neutrophil counts recovered and images did not deteriorate.
