Infectious complications in paediatric bone marrow transplantation

Abstract

Infections remain one of the major complications of bone marrow transplantation (BMT). Among the first 23 allogeneic paediatric BMT carried out in Queen Mary Hospital from September 1991 to January 1995, there were 68 episodes of infectious complications. These included 19 (28%) pyrexia of unknown origin, 11(16%) clinically documented infections, and 38(56%) microbiologically documented infections. The pathogens identified were of bacterial (n=22, 58%), mycobacterial (n=2, 5%), fungal (n=4, 10%), viral (n=9, 24%) and protozoal (n=1, 3%) in origin, including 21 episodes of bacteraemia. Five children died after BMT of which 4 were directly related to infections (sinopulmonary aspergillosis 2, cytomegalovirus pneumonitis 1, microsporiosis 1). Thus infectious complication is a major cause of morbidity and mortality in children receiving BMT. Thorough investigation for the focus and cause of infections is a pre-requisite for successful management.