الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Acute leukemia patients are prone to infections due to host factors predisposing them to infectious complications, such as neutropenia, disruption of mucosal barriers and the use of corticosteroids and other immune suppressive agents.
Despite improvements in diagnosis, prophylaxis, and treatment, invasive fungal infections (IFIs) remain a significant cause of morbidity and mortality in patients with acute leukemia.
The aim of this study was to detect the prevalence of invasive fungal infections in acute leukemia patients with neutropenic fever admitted at hematology department in Alexandria Main University Hospital.
This study was conducted on 50 acute leukemia patients during the period from April 2019 to January 2020.
Patients were subjected to thorough history taking ,Complete clinical examination including signs of infection, bone marrow examination and immunephenotyping and routine laboratory investigations including complete blood count , liver, renal functions tests , serum uric acid, electrolytes , prothrombin time, international normalized ratio, activated partial thromboplastin time, sepsis markers e.g CRP.
They were also subjected to radiological evaluation through computerized tomography scans of the chest and paranasal sinuses when indicated, and Serological markers including serum galactomannan antigen assay and serum mannan antigen assay by ELISA technique.
During neutropenic fever, all these patients were subjected to different cultures sampling ( blood cultures for all patients, sputum cultures for patients who could expectorate appropriate sample for culture, urine cultures for patients with pyuria and dysuria and pus cultures for patients presented with abscesses as a source of infection)
Our study included 50 acute leukemia patients , 43 diagnosed with AML and 7 patients diagnosed with ALL. As regards age , patients age ranged from 18 to 60 years, with a mean of 28.3 ± 9.8 in ALL patients and a mean of 41.8±11.9 in AML patients.
Regarding cultures results, none of cultures was positive for fungal infection while 19 of all 50 patients included in this study had positive bacterial cultures results. 11 of 18 (61%) patients who died had positive bacterial cultures results, while only 8 of 32 (25%) alive patients had positive cultures results. This difference was statistically significant (P=0.012).
Serum galactomannan antigen was positive in three patients , while serum mannan antigen was positive in one patient. Symptoms in patients with galactomannan antigen positive results were pleuritic pain (in two patients) and facial swelling (in the third patient who was discovered to have invasive fungal sinusitis). Pleuritic pain support the diagnosis of invasive pulmonary aspergillosis as stated in literature.