{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:02:50Z","timestamp":1782795770636,"version":"3.54.5"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Hepatosplenic fungal infection (<jats:styled-content style=\"fixed-case\">HSFI<\/jats:styled-content>) is a severe invasive fungal infection observed during neutrophil recovery in patients with acute leukaemia treated with intensive chemotherapy. Retrospective analysis including all paediatric haematological malignancies patients with <jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content> treated in Children Cancer Hospital Egypt (2013\u20102018). Twenty\u2010five patients with acute leukaemia developed <jats:styled-content style=\"fixed-case\">HSFI<\/jats:styled-content> (19 patients diagnosed as hepatosplenic candidiasis). Most of the cases (92%) occurred during the induction phase. Organs affected were as follows: liver in 18 patients, renal in 13 patients, spleen in 12 patients, skin in four patients and retina in one patient. Five (20%) patients had proven <jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content>, 14 (56%) probable and six (24%) possible <jats:styled-content style=\"fixed-case\">HSFI<\/jats:styled-content>. Ten patients had a <jats:styled-content style=\"fixed-case\">PET<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> for response assessment. Candida tropicalis was the most common isolated spp. from blood\/tissue culture. Six (24%) patients developed <jats:styled-content style=\"fixed-case\">HSFI<\/jats:styled-content> on top of antifungal prophylaxis. Steroids were given in 12 (52%) patients with <jats:styled-content style=\"fixed-case\">HSFI<\/jats:styled-content> as immune reconstitution syndrome (<jats:styled-content style=\"fixed-case\">IRS<\/jats:styled-content>). Caspofungin was the first line of treatment in 14 (56%) patients, liposomal amphotericin B in six (24%) patients and azoles in five (20%) patients. <jats:styled-content style=\"fixed-case\">HSFI<\/jats:styled-content> was associated with delayed of intensification phase of chemotherapy (median 42\u00a0days). The success rate was reported in 24 patients with complete response (68%) and partial response in (28%) patients, while failure (death) seen in 1(4%) patient. <jats:styled-content style=\"fixed-case\">HSC<\/jats:styled-content> is still a major challenge in paediatric leukaemias patients with impact on treatment delay and survival outcome. <jats:styled-content style=\"fixed-case\">PET<\/jats:styled-content> scan, non\u2010culture diagnostics and steroid role evidence in <jats:styled-content style=\"fixed-case\">IRS<\/jats:styled-content> are growing. Antifungal stewardship for screening, early detection for high\u2010risk patients and better response assessment is challenging.<\/jats:p>","DOI":"10.1111\/myc.13002","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T22:48:36Z","timestamp":1568328516000},"page":"30-37","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Clinical features and outcome of hepatosplenic fungal infections in children with haematological malignancies"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0511-1562","authenticated-orcid":false,"given":"Youssef","family":"Madney","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology, National Cancer Institute, Cairo University Children Cancer Hospital Egypt (CCHE) Cairo 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