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Gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy in the years 2000.
Open accessAbstract
AIM: To review gastrointestinal and liver infections in children undergoing antineoplastic chemotherapy. To look at gut microflora features in oncology children. METHODS: We selected studies published after year 2000, excluding trials on transplanted pediatric patients. We searched English language publications in MEDLINE using the keywords: "gastrointestinal infection AND antineoplastic chemotherapy AND children", "gastrointestinal infection AND oncology AND children", "liver infection AND antineoplastic chemotherapy AND children", "liver abscess AND chemotherapy AND child", "neutropenic enterocolitis AND chemotherapy AND children", "thyphlitis AND chemotherapy AND children", "infectious diarrhea AND children AND oncology", "abdominal pain AND infection AND children AND oncology", "perianal sepsis AND children AND oncology", "colonic pseudo-obstruction AND oncology AND child AND chemotherapy", "microflora AND children AND malignancy", "microbiota AND children AND malignancy", "fungal flora AND children AND malignancy". We also analysed evidence from several articles and book references. RESULTS: Gastrointestinal and liver infections represent a major cause of morbidity and mortality in children undergoing antineoplastic chemotherapy. Antineoplastic drugs cause immunosuppression in addition to direct toxicity, predisposing to infections, although the specific risk is variable according to disease and host features. Common pathogens potentially induce severe diseases whereas opportunistic microorganisms may attack vulnerable hosts. Clinical manifestations can be subtle and not specific. In addition, several conditions are rare and diagnostic process and treatments are not standardized. Diagnosis may be challenging, however early diagnosis is needed for quick and appropriate interventions. Interestingly, the source of infection in those children can be exogenous or endogenous. Indeed, mucosal damage may allow the penetrance of endogenous microbes towards the bowel wall and their translocation into the bloodstream. However, only limited knowledge of intestinal dysbiosis in oncology children is available. CONCLUSION: The diagnostic work-up requires a multimodal approach and should be implemented (also by further studies on new biomarkers) for a prompt and individualized therapy.
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“For moderate or severe disease, particularly in oncologic patients, the first-line treatment is oral metronidazole (30 mg/kg/day); oral vancomycin is reserved for resistant strains 37, 38.”
From Antibiotic treatment of acute gastroenteritis in children (2018) · cites this paper as [38]
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“Also, in children with cancer, intestinal infections are a major threat and require a comprehensive diagnostic approach 38 .”
BackgroundSelf-citation
Metadata
- Authors
- Castagnola, E., Ruberto, E., & Guarino, A.
- Affiliations
- Istituto Giannina Gaslini (IT)
- Corresponding author
- Castagnola, Elio
- Venue
- World Journal of Gastroenterology
- Publisher
- Baishideng Publishing Group Inc.
- Published
- 2016
- Volume
- 22
- Issue
- 25
- Pages
- 5853
- ISSN
- 1007-9327 (ISSN-L)
- PMC
- PMC4932220
- OpenAlex
- W2474201830
- Cited by
- 17
- References
- 178
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 2 · 2017: 2
- FWCI
- 0.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- World Journal of Gastroenterology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Keywords
- gastrointestinal infections, liver infection, pediatric oncology, cancer chemotherapy, neutropenic enterocolitis, liver abscess, infectious diarrhea, colonic pseudo-obstruction, perianal sepsis, gut dysbiosis, gut microbiota, immunosuppression, opportunistic infections, endogenous infection, exogenous infection, diagnostic workup
- MeSH terms
- Gastrointestinal Microbiome, Adolescent, Antineoplastic Agents, Child, Colonic Pseudo-Obstruction, Diarrhea, Gastroenteritis, Hepatitis, Viral, Human, Humans, Liver Abscess, Liver Diseases, Mycoses, Neoplasms, Immunocompromised Host, Sepsis, Enterocolitis, Neutropenic, Dysbiosis
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