scholarly journals Clinical Epidemiology and Risk Factors of Candida auris Bloodstream Infection in Trauma Patients

2020 ◽  
Vol 41 (S1) ◽  
pp. s168-s168
Author(s):  
Omika Katoch ◽  
Vijeta Bajpai ◽  
Surbhi Khurana ◽  
Sonal Katyal ◽  
Purva Mathur
Keyword(s):  
Risk Factors ◽  
Broad Spectrum ◽  
Clinical Epidemiology ◽  
Fungal Infections ◽  
Major Surgery ◽  
Trauma Patients ◽  
Candida Auris ◽  
Becton Dickinson ◽  
Broad Spectrum Antibiotics ◽  
Hospital Acquired

Background: Candidiasis caused by Candida auris is one of the most serious hospital-acquired infection. Initially, Candida auris was reported to cause local infections; later, invasive candidasis was also reported in which the bloodstream, the central nervous system, kidneys, liver eyes, etc, are invaded. In this study, we evaluated the clinical epidemiology and risk factors in patients hospitalized to trauma center. Methods: This study was conducted at JPN Apex Trauma Centre of All India Institute of Medical Sciences, New Delhi, which is a 169-bed hospital. All patients who were identified to have candidemia due to C. auris over a period of 5 years from January 2012 to December 2016 were included. Blood samples were collected in BAC-T-Alert bottles (Bio Merieux, Durham, NC) and isolates were identified up to the species level by the VITEK 2 (version 8.01, BioMerieux). Conventional identification was performed by observing color development on CHROMagar (Becton Dickinson, Franklin Lakes, NJ). The demographic and clinical data of patients were collected from the hospital information system. Results: Over a period of 5 years, 20 patients admitted to our trauma hospital developed candidemia due to Candida auris. Among them, men were predominant (95%), and the mean (SD) age of the patients was 33 (+15) years. Among these patients, 80% were in hospitalized and 20% were follow-up patients. The median of the total length of stay in the hospital was 34 days (range, 7–122). All of the patients were on mechanical ventilation; 65% patients were catheterized and 75% patients had central line placed. Head injury was the major cause of trauma followed by abdomen, chest, and spine. The overall mortality rate was 40%. Most of the patients (65%) who developed Candida auris infection were immunocompromised. The different comorbidities present were hypertension (35%), diabetes (15%), renal disease (10%), and hepatitis C (5%). Broad-spectrum antibiotics were given: amoxicillin-clavulanate was given to 65% of patients; cefoperazone sulbactam was given to 30% of patients; chloroamphenicol, amicillin-sulbactam, or clindamycin was given to 10% of patients. Antifungal agents like fluconazole or caspofungin were given to 5% of patients. Major surgeries like cranioplasty were performed in 58% of patients. Pancreatectomy, laparotomy, and endoscopic necrosectomy were performed in 42% of patients. Conclusions:Candida auris is one of the dreaded and most commonly spread hospital-acquired fungal infections, especially in immunocompromised patients. Broad-spectrum antibiotics use, major surgery, and invasive devices were the most common risk factors for acquiring Candida auris infection.Funding: NoneDisclosures: None

scholarly journals Risk Factors of Invasive Pulmonary Fungal Infections in Patients with Hepatitis B Virus Related Acute-on-Chronic Liver Failure

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Xinchun He ◽  
Shigang Tang ◽  
Liang Chen ◽  
Yuqing Feng ◽  
Baining Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Broad Spectrum ◽  
Total Bilirubin ◽  
Fungal Infections ◽  
International Normalized Ratio ◽  
Serum Total Bilirubin ◽  
Chronic Liver Failure ◽  
Broad Spectrum Antibiotics ◽  
B Virus ◽  
Pulmonary Fungal Infections

To analyze the risk factors of invasive pulmonary fungal infections in patients with HBV-ACL, the clinical data and risk factors of 60 patients with HBV-ACLF complicated IPFI were analyzed retrospectively including clinical parameters, broad-spectrum antibiotics usage, neutropenia, invasive medical manipulations, serum total bilirubin, international normalized ratio (INR), and MELD scores were compared with non-IPFI. Risk factors were analyzed using mathematical tools. Candida species and Aspergillus were detected as the most prominent fungal strains (61.11% and 33.33%, respectively). The risk factors included prolong broad-spectrum antibiotic usage OR = 4.362 , P = 0.008 , neutropenia OR = 3.288 , P = 0.007 , invasive procedures OR = 3.263 , P = 0.010 , serum total bilirubin OR = 1.006 , P = 0.011 , INR OR = 2.101 , P = 0.007 , and MELD scores OR = 1.074 , P = 0.008 . Candida is the main IPFI strains in patients with HBV-ACLF. Broad-spectrum antibiotics usage, neutropenia, invasive manipulations, and the severity of ACLF might be risk factors for IPFI in patients with HBV-ACLF.

scholarly journals 1033. Thinking Outside the Bowel: Clostridium difficile Bacteremia Case Series

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S308-S308 ◽  
Author(s):  
Adam Pettigrew ◽  
Ripal Jariwala ◽  
Kristen Zeitler ◽  
Jose Montero ◽  
Sandra Gompf ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Clostridium Difficile ◽  
Bloodstream Infection ◽  
Broad Spectrum ◽  
Case Series ◽  
Prior History ◽  
Broad Spectrum Antibiotics ◽  
History Of ◽  
Polymicrobial Bacteremia ◽  
Hospital Acquired

Abstract Background While Clostridium difficile gastrointestinal infection (CDI) is the most common hospital-acquired infectious disease, C. difficile bacteremia (CDB) is exceedingly rare and its risk factors, mortality rate, and modalities of treatment are not well defined. Methods We conducted a retrospective, IRB approved, chart review of adult patients with a diagnosis of CDB admitted to our institutions from 2011 through 2017. Variables catalogued included previous antibiotic and proton pump inhibitor (PPI) use, co-morbid conditions, prior history of CDI, diarrhea at the time of CDB, active malignancy, and gastrointestinal (GI) disruption (e.g., perforated viscous, GI bleeding, abdominal malignancy). Treatment courses and outcomes for CDB were also gleaned. Results Seven patients with CDB were identified, with ages ranging from 35 to 81 years (median 65 years). Six (85.7%) patients had evidence of GI disruption and three (42.9%) were noted to have active cancer. Three (42.9%) patients had previous CDI by testing and three (42.9%) had complaints of diarrhea at the time of diagnosis. Six (85.7%) patients had exposure to PPIs before CDB diagnosis, and five (71.4%) had prior antibiotic exposure in the past 30 days. Five (71.4%) patients had a polymicrobial bloodstream infection, with the majority of organisms being enteric in nature. In terms of CDB treatment, the majority of patients received intravenous (IV) metronidazole and/or IV vancomycin in addition to broad-spectrum antibiotics due to the polymicrobial nature of their infection. Three (42.9%) patients died during their hospitalization, only one who had polymicrobial bacteremia. Conclusion CDI is the most common cause of hospital acquired infection, although rarely causes bacteremia. Notable findings in our population included older age, concomitant malignancy, evidence of GI disruption, and prior exposure to PPIs and antibiotics. Antibiotics chosen to treat CDB were IV metronidazole and/or IV vancomycin, with other broad-spectrum antibiotics utilized due to polymicrobial bacteremia. CDB is associated with a high mortality rate and is commonly manifested as a polymicrobial bloodstream infection. This is one of the larger case series that adds to the scant literature characterizing patients diagnosed with CDB. Disclosures All authors: No reported disclosures.

Effectiveness of Antibacterial Prophylaxis during Induction Chemotherapy in Children with Acute Lymphoblastic Leukemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 249-249 ◽  
Author(s):  
Maria Luisa Sulis ◽  
Traci M. Blonquist ◽  
Uma H. Athale ◽  
Luis A. Clavell ◽  
Peter D. Cole ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Broad Spectrum ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Induction Phase ◽  
Newly Diagnosed ◽  
Broad Spectrum Antibiotics ◽  
Bacterial C ◽  
Count Recovery

Abstract Background. Pediatric patients with newly diagnosed acute lymphoblastic leukemia (ALL) are at high risk for developing bacterial infections, particularly during the induction treatment phase. Infections are the primary cause of treatment-related mortality during the induction phase, and also lead to prolonged hospitalization, as well as delays and dose modifications in planned chemotherapy. On DFCI ALL Consortium Protocol 05-001 (2005-2011), 26.6% of 794 enrolled patients (pts) experienced at least one infectious complication during induction. In the subsequent study, DFCI Protocol11-001, we studied whether the use of prophylactic fluoroquinolones during induction would decrease the incidence of bacterial infections. Patients and methods.Between 2012-2015, 229 pts with ALL (aged 1-21 years) were enrolled on Protocol 11-001 at 9 participating sites. Induction therapy, regardless of risk group, included vincristine, methylprednisolone, doxorubicin, low-dose methotrexate and pegylated L-asparaginase. Afebrile pts were started on fluoroquinolone prophylaxis at the time of initiation of therapy and continued until count recovery at the end of induction. Pts were switched to broad-spectrum antibiotics (eg, cefepime) for fever or documented infection. Pts with fever at presentation were started on broad spectrum antibiotics rather than fluoroquinolone, and either remained on broad-spectrum antibiotics or were switched to fluoroquinolone prophylaxis until count recovery per treating clinician. Antifungal prophylaxis was not required. All episodes of microbiologically documented bacterial infection, microbiologically and/or radiographically documented fungal infection, and Clostridium difficile (C. diff) enterocolitis were prospectively collected. Using a 1-sample binomial test, rates of infections on Protocol 11-001 were compared to those from the predecessor study, DFCI Protocol 05-001, which included nearly identical induction chemotherapy but did not include guidelines regarding antibiotic prophylaxis or duration during induction. Results. Of the 229 pts, 89% had B-ALL and 11% T-ALL. Median age was 5.1 yrs (range 1.0-20.9). Eighty-six afebrile pts (37.5%) were administered upfront antibiotic prophylaxis and 141 (61.6%) had fever at diagnosis and received broad-spectrum antibiotics; two afebrile patients did not receive antibiotic prophylaxis for unknown reasons. Of the 86 pts who began prophylaxis, 37 (43%) subsequently developed fever. Toxicity data was available for 222 pts. Thirty-eight episodes of infection occurred in 29 patients. Age, presenting white blood cell count and immunophenotype were not associated with the development of infection. The proportion of pts experiencing an infection on Protocol 11-001 (13.1%) was significantly lower than on Protocol 05-001 (26.6%, p<0.0001) [Figure 1]. The observed reduction was due to a decrease in the incidence of bacterial infection (9.9% vs 24.7%, p<0.0001). Of note, there were significantly fewer episodes of bacteremias due to Gram negative rods, S. aureus and S. viridans on Protocol 11-001 compared to 05-001. There was no significant difference in incidence of fungal infection between the two protocols (4.5% vs 3.9%, p=0.32). Twenty (9%) pts on 11-001 developed C. diff colitis during induction (16 Grade 2, 3 Grade 3, 1 Grade 4). The induction death rate on Protocol l 11-001 was 0.9% compared with 2% on Protocol 05-001 (p=0.24). Conclusion.The results of our prospective, multi-institutional non-randomized study indicate that treating newly diagnosed pediatric ALL pts with antibiotics throughout the induction phase (including the use of antibiotic prophylaxis for afebrile pts) is effective at reducing the incidence of bacterial infections, and does not result in an increase in fungal infections or a high incidence of C. diff colitis. Additional larger, randomized studies are necessary to confirm the safety and efficacy of this approach during the induction phase. Figure 1. Rate of induction (A) overall (bacterial/fungal), (B) bacterial, (C) fungal infections on Protocols 05-001 and 11-001 Figure 1. Rate of induction (A) overall (bacterial/fungal), (B) bacterial, (C) fungal infections on Protocols 05-001 and 11-001 Disclosures No relevant conflicts of interest to declare.

scholarly journals Ventilator Associated Pneumonia in Pediatric Trauma Patients

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Dalton Sullivan ◽  
Matthew P. Landman ◽  
Rachel E. Gahagen Gahagen
Keyword(s):  
Risk Factors ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Hospital Acquired Infection ◽  
Trauma Population ◽  
Hospital Acquired ◽  
Cultured Bacteria ◽  
The Impact ◽  
Overall Mortality

Background: Ventilator associated pneumonia (VAP) is a common hospital-acquired infection found in intubated trauma patients. In previous adult studies, VAP has been associated with an increase in length of stay, cost, morbidity, mortality, and longer mechanical ventilation. There remains little examination of the risk factors, prognosis, and microbiology of VAP within the pediatric trauma population. This study aims to analyze factors associated with VAP in pediatric trauma patients. Methods: The Riley Hospital for Children Trauma Registry was utilized to identify intubated pediatric trauma patients from 2016-2020. Patients were excluded if intubated for less than 48 hours.   VAP was defined as positive if patients met either Centers for Disease Control definition and or were clinically diagnosed with and treated for VAP. Univariate and multivariate modeling was performed. Results: A total of 171 patients met inclusion criteria and 43 (25%) were diagnosed with VAP. The median age was 8 years (2-13) and ISS was 26.5 (22-35). The median duration of intubation was 203.8 hours (117.3-331.3). The overall mortality was 55 (32.2%). While variables such as lower age and use of MTP resulted in a higher likelihood of mortality, VAP diagnosis was not associated with increased mortality. BAL analysis displayed that the most common cultured bacteria were H. influenzae, Staph. aureus, and Strep. Pneumoniae with most VAPs being diagnosed on day 2 of admission. When analyzing the impact of age, ISS, intubation hours, ICU days, and GI prophylaxis on VAP, only age was significantly associated with VAP: for each year the odds of VAP rose by 10%. Conclusions: A quarter of the pediatric trauma patients were diagnosed with VAP during the study period.  No modifiable risk factors were found for VAP with only patient age demonstrating significance for the diagnosis.  Further investigation into VAP definition and prevention in pediatric trauma patients should occur given it’s prevalence.

scholarly journals Clostridium difficile infection in an academic medical center in Saudi Arabia: prevalence and risk factors

2020 ◽  
Vol 40 (4) ◽  
pp. 305-309
Author(s):  
Mai Alalawi ◽  
Seba Aljahdali ◽  
Bashaer Alharbi ◽  
Lana Fagih ◽  
Raghad Fatani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Broad Spectrum ◽  
Medical Center ◽  
Academic Medical Center ◽  
Infection Prevalence ◽  
Healthcare Facilities ◽  
Broad Spectrum Antibiotics ◽  
Academic Medical ◽  
Significant Difference

ABSTRACT BACKGROUND: Clostridium difficile infection is one of the most common causes of diarrhea in healthcare facilities. More studies are needed to identify patients at high risk of C difficile infection in our community. OBJECTIVES: Estimate the prevalence of C difficile infection among adult patients and evaluate the risk factors associated with infection. DESIGN: Retrospective record review. SETTING: Tertiary academic medical center in Jeddah. PATIENTS AND METHODS: Eligible patients were adults (≥18 years old) with confirmed C difficile diagnosis between January 2013 and May 2018. MAIN OUTCOME MEASURES: Prevalence rate and types of risk factors. SAMPLE SIZE: Of 1886 records, 129 patients had positive lab results and met the inclusion criteria. RESULTS: The prevalence of C difficile infection in our center over five years was 6.8%. The mean (SD) age was 56 (18) years, and infection was more prevalent in men (53.5%) than in women (46.5%). The most common risk factors were use of proton-pump inhibitors (PPI) and broad-spectrum antibiotics. The overlapping exposure of both PPIs and broad-spectrum antibiotics was 56.6%. There was no statistically significant difference between the type of PPI ( P =.254) or antibiotic ( P =.789) and the onset of C difficile infection. CONCLUSION: The overall C difficile infection prevalence in our population was low compared to Western countries. The majority of the patients who developed C difficile infection were using PPIs and/or antibiotics. No differences were observed in the type of antibiotic or PPI and the onset of C difficile infection development. Appropriate prescribing protocols for PPIs and antibiotics in acute settings are needed. LIMITATIONS: Single center and retrospective design. CONFLICT OF INTEREST: None.

scholarly journals Derivatives of the antimalarial drug mefloquine are broad spectrum antifungal molecules with activity against drug-resistant clinical isolates

2019 ◽  
Author(s):  
Marhiah C. Montoya ◽  
Sarah Beattie ◽  
Kathryn M. Alden ◽  
Damian J. Krysan
Keyword(s):  
Antifungal Activity ◽  
Mechanism Of Action ◽  
Broad Spectrum ◽  
Fungal Infections ◽  
Clinical Isolates ◽  
In Vitro Toxicity ◽  
Drug Resistant ◽  
Candida Auris ◽  
Recent Emergence ◽  
Derivatives Of

ABSTRACTThe antifungal pharmacopeia is critically small, particularly in light of the recent emergence of multi-drug-resistant pathogens such as Candida auris. Herein, we report that derivatives of the anti-malarial drug mefloquine have broad spectrum antifungal activity against pathogenic yeasts and molds. In addition, the mefloquine derivatives have activity against clinical isolates that are resistant to one or more of the three classes of drugs currently used to treat invasive fungal infections, indicating that they have a novel mechanism of action. Importantly, the in vitro toxicity profiles using human cell lines indicate that the mefloquine derivatives are very similar to the parent mefloquine despite being up to 64-fold more active against fungal cells. In addition to direct antifungal activity, sub-inhibitory concentrations of the mefloquine derivatives inhibit the expression of virulence traits including filamentation in C. albicans and capsule formation/melanization in C. neoformans. Mode/mechanism of action experiments indicate that the mefloquine derivatives interfere with both mitochondrial and vacuolar function as part of a multi-target mechanism of action. The broad-spectrum scope of activity, blood-brain-barrier penetration, and large number of previously synthesized analogs available combine to support the further optimization and development of the antifungal activity of this general class of drug-like molecules.

scholarly journals Incidence, risk factors, phathophisiology and modern aspects of therapy of feline pyometra

2019 ◽  
pp. 54-60
Author(s):  
Georgy Petrovich Dyulger ◽  
Yuliya Gennadievna Sibileva ◽  
Maria Aleksandrovna Yakovleva Maria ◽  
Peter Georgievich Dyulger ◽  
Evgeniya Sergeevna Sedletskaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Detection ◽  
Inflammatory Response ◽  
Broad Spectrum ◽  
Clinical Manifestations ◽  
Systemic Inflammatory Response ◽  
Clinical Forms ◽  
Broad Spectrum Antibiotics ◽  
Incidence Risk

The article provides an overview of the frequency of distribution of pyometra in cats. Risk factors, clinical manifestations and clinical forms of the disease are analyzed. Current methods of pyometra diagnostics and clinical and laboratory criteria for early detection of signs of sepsis (systemic inflammatory response) in cats with pyometra are considered. The methods of pyometra therapy are analyzed. It was emphasized that the most effective and safest method of treating any form of pyometra is a total ovariohisterectomy in combination with broad-spectrum antibiotics. Encouraging results in the treatment of an open uncomplicated form of pyometers in cats were obtained using, along with antibiotics, preparations based on PgF2alfa and aglepristone.

scholarly journals Candida auris: A rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally

2017 ◽  
Vol 13 (5) ◽  
pp. e1006290 ◽  
Author(s):  
Anuradha Chowdhary ◽  
Cheshta Sharma ◽  
Jacques F. Meis
Keyword(s):  
Fungal Infections ◽  
Multidrug Resistant ◽  
Candida Auris ◽  
Hospital Acquired

scholarly journals 248. Thirty-Day Mortality Among Patients with Candidemia Diagnosed by T2Candida Assay Alone: Influence of Risk Factors and Candida Species

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S140-S140
Author(s):  
Cameron White ◽  
Todd McCarty ◽  
Rachael A Lee ◽  
Sixto M Leal ◽  
Peter Pappas
Keyword(s):  
Risk Factors ◽  
Antifungal Therapy ◽  
Broad Spectrum ◽  
Candida Species ◽  
Limit Of Detection ◽  
Medical Center ◽  
Clinical Signs ◽  
Mortality Rates ◽  
Mortality Data ◽  
Broad Spectrum Antibiotics

Abstract Background Candidemia is a common cause of healthcare-associated bloodstream infection with high mortality rates despite antifungal therapy. Risk factors include prolonged ICU stay, immunosuppression, and exposure to broad-spectrum antibiotics. Blood cultures (BC) remain the gold standard for diagnosis but lack sensitivity and can take days to result. T2Candida (T2C) is a rapid diagnostic test utilizing PCR and magnetic resonance technology to detect five Candida species in whole blood in less than 6 hours. In this study we examined characteristics of patients with positive T2C assays in the absence of positive BC including risk factors and 30-day mortality rates. Methods We conducted a retrospective analysis of positive T2C cases at UAB Medical Center from 2016 to 2018 with either negative or no BC. For each patient we determined if clinical signs (e.g., hypotension, leukocytosis) and risk factors for candidemia were present at the time of collection. Our primary outcome of interest was 30-day mortality. Data were compared by multivariate analysis. Results A total of 173 patients with T2C positivity alone were included in the analysis. The most common risk factor was the use of broad-spectrum antibiotics followed by CVC (Table 1). The mean number of risk factors per patient was 3.6 (Figure 1). Overall 30-day mortality was 41%. Patients with a T2C result of C. albicans/C. tropicalis were almost 2.5 times more likely to die at 30 days (aOR 2.401, CI 1.159–4.974) compared with those with other positive results. Increasing number of risk factors (aOR 1.457, CI 1.126–1.886) and increasing age (aOR 1.052, CI 1.026–1.079) were significantly associated with increased odds of death at 30 days (Table 2). Conclusion In this study we demonstrate a significant association between increasing number of risk factors, older age, and A/T result with higher odds of 30-day mortality among patients with T2C positivity alone. While concern for false-positives exists when using T2C, our data suggest that this is an acutely ill population which warrants early and aggressive antifungal therapy. The lower limit of detection of T2C (1 cfu/mL) as compared with BC may explain lack of paired positive cultures in these patients despite clinical signs of and risk factors for candidemia. Disclosures All authors: No reported disclosures.

scholarly journals Infectious Esophagitis in Romanian Children: From Etiology and Risk Factors to Clinical Characteristics and Endoscopic Features

2020 ◽  
Vol 9 (4) ◽  
pp. 939
Author(s):  
Mădălina Adriana Bordea ◽  
Alexandru Pîrvan ◽  
Dan Gheban ◽  
Ciprian Silaghi ◽  
Iulia Lupan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Tract ◽  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Post Mortem ◽  
Appetite Loss ◽  
Broad Spectrum Antibiotics ◽  
Prolonged Antibiotic Therapy

Objectives. The aim of this study is to provide information about prevalence, etiology, risk factors, clinical characteristics and endoscopic features of various types of infectious esophagitis in children. Methods. We performed a total of 520 upper gastrointestinal tract endoscopies in Pediatric Clinic II, Emergency Hospital for Children, Cluj-Napoca. Indications for endoscopy in our cohort were gastrointestinal tract symptoms such as dysphagia, heartburn, or appetite loss. Results. The prevalence of infectious esophagitis in the study population was 2.11% (11 patients). Candida albicans (C. albicans) was the most frequent cause. Our data illustrates that herpes simplex virus (HSV)-induced esophagitis is common in immunocompromised patients and should be systematically suspected in cases of severe dysphagia, heartburn, or hematemesis. In the present study, all cytomegalovirus (CMV) esophagitis patients were immunocompromised. Immunodeficiency (81.8%) and prolonged antibiotic therapy with broad-spectrum antibiotics were by far the most important risk factors involved in the pathogenicity of the disease. Dysphagia, appetite loss, heartburn, epigastralgia, and hematemesis were the main clinical manifestations. Infectious esophagitis was associated with significant mortality. In four patients, endoscopy during life showed signs of infectious esophagitis; however, the precise etiology was only established post-mortem, in the pathological anatomy laboratory department. A risk factor involved in pathogenesis of post-mortem diagnosed infectious esophagitis is the DiGeorge syndrome for CMV and HSV patients. Conclusions. The study illustrates that infectious esophagitis should be considered in immunocompromised infants with prolonged antibiotic therapy with broad-spectrum antibiotics.

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