Clinical observation of primary Epstein-Barr virus infection in children.
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Adolescent↗
Biomedical subjects
D C Liang
Publications and source records attributed to D C Liang.
Epstein-Barr virus pneumonia associated with hemophagocytic syndrome: report of one case.
An 8-year-old girl was admitted because of high fever and cough for seven days. The physical examination on admission revealed diffuse moist rales over the left lung field. Her high fever persisted, and she subsequently developed hepatosplenomegaly, lymphadenopathy, skin rashes, subconjunctival hemorrhage, diffuse pulmonary infiltrates, abnormal liver function, anemia, thrombocytopenia, leukocytosis, and hypoalbuminemia. A bone marrow study revealed increased numbers of macrophages with apparent hemophagocytosis. She developed respiratory failure and required artificial ventilation, but finally died despite resuscitative efforts. Serology for EB virus initially revealed negative findings, but on the 24th day after admission, showed IgG antibody to viral capsid antigen 320x (+), and IgM antibody to viral capsid antigen (+). This is a very unusual case of fatal EB virus pneumonia associated with hemophagocytic syndrome.
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Bacteremia in children with acute lymphoblastic leukemia.
Bacteremia is one of the important complications of the treatment of hematological malignancy. In this report, we analyze bacteremias in 72 children with acute lymphoblastic leukemia who were admitted to our hospital from July 1, 1988 to October 31, 1991. Positive blood cultures were found in 26% (19/72) of the patients. There were 24 episodes of bacteremia; Gram-negative, Gram-positive and mixed bacteremia comprised 62.5% (15/24), 33.3% (8/24) and 4.2% (1/24), respectively. E. coli, klebsiella pneumoniae and Pseudomonas aeruginosa were the three most common pathogens. Eighty-three percent of the bacteremic episodes occurred during neutropenia (absolute neutrophil count below 500/mm3). Our data suggest that a Pseudomonas etiology, associated pneumonia, and shock accounted for a poor outcome. The over-all mortality for bacteremic events was 26.3% (5/19). Intensive supportive treatment and effective antibiotics are the most important factors in improving the outcome of bacteremia. The success in recent ALL treatment can be attributed in part to the improved outcome of bacteremia.
Adolescent↗
Intelligence quotient in childhood acute lymphoblastic leukemia after prophylactic treatment in central nervous system with 18 Gy cranial irradiation and intrathecal methotrexate.
The purpose of this study is to evaluate whether central nervous system prophylactic treatment (CNSP) with cranial irradiation therapy (CrRT) 18 Gy and intrathecal methotrexate would decline the intelligence quotient (IQ) scores of children with acute lymphoblastic leukemia (ALL). In protocol TCL 842, children with ALL received CrRT 18 Gy in 12 fractions, and 5 concomitant doses of intrathecal methotrexate 15 mg/m2/dose with 15 mg as the maximum, for CNSP after remission achieved. The first IQ test was performed immediately after CNSP. Those who had no CNS relapse for more than 5 years after CNSP had a second IQ test. For children between 3 and 6 years old, the Stanford-Binet (S-B) IV test was used, and for older children, the Wechsler Intelligence Scale for Children-Revised (WISC-R) was used. Fourteen consecutive children at our hospital were enrolled. There were 7 boys and 7 girls. The age at diagnosis ranged from 3 to 9 years old. Two of them were in the high-risk group, eight in the intermediate-risk group, and four in the standard-risk group. The IQ scores of all patients fell within the average range. In the first IQ tests, the mean IQ score was 104.29 (range 83-124, S.D. 14.55). In the second IQ tests, the mean IQ score was 100.93 (range 85-128, S.D. 11.57). Statistically, there was no significant difference between the first and second IQ scores (paired t-test, two-tailed P = 0.4232; one-tailed P = 0.2116). Our findings suggested that CNSP used in protocol TCL 842 did not reduce IQ scores of children with ALL 5 years after CNSP.
Adolescent↗