الفهرس 
OPPORTUNISTIC FUNGAL INFECTIONSOnly 14 pages are availabe for public view
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Abstract
Background; Fungal infection is a serious problem in Pediatric intensive care
unit (PICU) non-neutropenic patients, as risk factors are still poorly defined. The
diagnosis remains difficult, and most of previous literatures concerned about fungal
infections in neutropenic adults. Objectives; To determine different species, risk
factors, underlying illness, diagnosis, treatment, and outcome of fungal infections in
PICU patients. Methods; The study included 40 patients out of 197 PICU admissions
over 12 months who were found to be at high risk for fungal infections. They were
subjected to; Pediatric Risk of Mortality (PRISM III) score and organ failure
assessments, Chest X-ray, blood and endo-tracheal aspirate samples (ETA) cultured
on Sabouraud’s dextrose agar, fungal species were identified by microscan 9696
semi-automated system, then blood and ETA were examined for fungal antigens
(mannan and galactomannan) by Enzyme Linked Immunosorbent Assay test. SPSS
test was used for statistical analysis. Results; Fungal infection was diagnosed in 20
patients (50%). Seventeen candida isolates were detected from both ETA and blood, 2
aspergillus isolates from both ETA and blood and 7 yeasts other than candida were
isolated from ETA. Significant risk factors found; higher PRISM score, multi-organ
system failure, and thrombocytopenia. ETA had a higher diagnostic yield in
comparison to blood, and fungal antigens detection was significantly higher than
cultures. The overall mortality was 25% in patients at risk for fungal infection, 40% in
patient proven to have fungal infection Conclusion; Fungal infection is a serious
problem in our PICU, with high mortality and morbidity in spite of treatment. ELISA
antigen detection for candida and aspergillus seems to be a useful tool for diagnosis.
(Key Words: candida, aspergillus, galactomannan, PICU).