2339. Perianal Infections in Children With Acute Myeloid Leukemia: A Report From the Canadian Infection in Acute Myeloid Leukemia Research Group
Bibliographic record
Abstract
Little is known about the epidemiology of perianal infection in pediatric cancer patients. Objectives were to describe the characteristics, treatment and outcome of perianal infection and describe features of those with and without definite abscess in pediatric patients with acute myeloid leukemia (AML). We performed a retrospective analysis of two multi-center cohort studies investigating risk factors for infection in children with AML. We included children with de novo AML ≤18 years of age with a perianal infections prior to the completion of AML treatment or stem cell transplantation Of 235 patients with AML, 17 (7%) experienced 19 perianal infections. Median age at perianal infection was 8.2 (range 0.6–16.1) years. Local bacterial cultures were positive in 6 (32%) episodes, but none matched bacteremia isolates (n = 5). Enterobacteriacae were the most common pathogen. The 19 episodes were stratified by definite abscess (n = 12) and cellulitis/phlegmon (n = 7). All patients presented with local pain, erythema and induration or swelling. Fever was a frequent finding (n = 17, 89.4%). Among the patients with abscess, 9 (75%) were severely neutropenic at diagnosis and surgical intervention was required in 8 (42%). All patients received antibiotics; Metronidazole (n = 14) and Piperacillin/Tazobactam (n = 10) were the drugs most frequently used for treatment. Imaging was commonly performed (n = 16). Diagnostic yield was similar between computerized tomography of pelvis (5/10) and ultrasound (3/5). Severe complications occurred including fistula (n = 1), skin necrosis (n = 2) and mortality (n = 1). Perianal infections occurred in 7% of pediatric patients with AML, with many consisting of definite abscess. Diagnostic yield were similar regardless of imaging modality and therefore, ultrasound may be considered for initial evaluation. Future research should develop consistent management approaches to perianal infection in order to improve outcomes. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".