OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press38410.17650/1818-8346-2019-14-4-59-66INFECTION PROBLEMS IN ONCOHEMATOLOGYПРОБЛЕМЫ ИНФЕКЦИЙ В ОНКОГЕМАТОЛОГИИBreakthrough invasive candidiasis in pediatric patient with Ewing’s sarcoma: dinical case report and literature reviewИнвазивный кандидоз на фоне антифунгальной профилактики у ребенка с саркомой Юинга: описание клинического случая и обзор литературыhttps://orcid.org/0000-0002-2003-0982DinikinaYu. V.ДиникинаЮ. В.
Russian Federation

2 Akkuratova St., Saint-Petersburg 197341; 2 Litovskaya St., Saint-Petersburg 194100

Юлия Валерьевна Диникина

197341 Санкт-Петербург, ул. Аккуратова, 2; 194100Санкт-Петербург, ул. Литовская, 2

dinikina_yuv@almazovcentre.ruhttps://orcid.org/0000-0002-3272-5263ShadrivovaO. V.ШадривоваО. В.
Russian Federation

1/28 Sant'yago-de-Kuba St., Saint-Petersburg 194291

194291 Санкт-Петербург, ул. Сантьяго-де-Куба, 1/28

https://orcid.org/0000-0002-7471-7181BelogurovaM. B.БелогуроваМ. Б.
Russian Federation

2 Akkuratova St., Saint-Petersburg 197341; 2 Litovskaya St., Saint-Petersburg 194100

197341 Санкт-Петербург, ул. Аккуратова, 2; 194100Санкт-Петербург, ул. Литовская, 2

IgnatyevaS. M.ИгнатьеваС. М.
Russian Federation

1/28 Sant'yago-de-Kuba St., Saint-Petersburg 194291

194291 Санкт-Петербург, ул. Сантьяго-де-Куба, 1/28

BogomolovaT. S.БогомоловаТ. С.
Russian Federation

1/28 Sant'yago-de-Kuba St., Saint-Petersburg 194291

194291 Санкт-Петербург, ул. Сантьяго-де-Куба, 1/28

https://orcid.org/0000-0001-6095-7531KlimkoN. N.КлимкоН. Н.
Russian Federation

1/28 Sant'yago-de-Kuba St., Saint-Petersburg 194291

194291 Санкт-Петербург, ул. Сантьяго-де-Куба, 1/28

Almazov National Medical Research Centre, Ministry of Health of RussiaФГБУ«Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава РоссииSaint-Petersburg State Pediatric Medical University, Ministry of Health of RussiaФГБОУВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава РоссииI.I. Mechnikov North-Western State Medical UniversityФГБОУ ВО Северо-Западный государственный медицинский университет им. И.И. МечниковаAlmazov National Medical Research Centre, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава России2212201914459662212201922122019https://oncohematology.abvpress.ru/ongm/article/view/384

We presented clinical case of invasive candidiasis in 13 years old girl with Ewing's sarcoma during intensive treatment with combined chemotherapy according EWING 2008 protocol. The most significant risk factors were recurrent chemotherapy induced neutropenia gr IV, multifocal Candida colonization, prolonged central venous catheter use, combined antibiotic therapy in the previous >10 days, parenteral nutrition. In spite of provided prophylaxis and antifungal therapy patient died because of progression of invasive candidiasis. We analyzed literature data on frequency of invasive candidiasis in children with Ewing's sarcoma and cases of breakthrough candidiasis in pediatric malignancies.

Представлен клинический случай инвазивного кандидоза, вызванного Candida albicans, у 13-летней пациентки с саркомой Юинга, получавшей интенсивную комбинированную химиотерапию согласно протоколу EWING 2008 и антифунгальную профилактику. Наиболее значимыми факторами риска были повторные эпизоды химиоиндуцированного агранулоцитоза, мультифокальная колонизация грибами рода Candida, длительное стояние центрального венозного катетера, комбинированная антибактериальная терапия (>10 дней), парентеральное питание. Несмотря на проводимую антифунгальную профилактику и последующую антимикотическую терапию, летальный исход ассоциирован с прогрессирующим течением инвазивного кандидоза. Мы проанализировали данные литературы по частоте инвазивного кандидоза у детей с саркомой Юинга и случаи «прорывного» инвазивного кандидоза при онкологических заболеваниях у детей.

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