A child with acute lymphoblastic leukemia develops systemic candidiasis. The nurse should know that which systems or sites are most commonly involved?

1. A

   Gastrointestinal tract and bloodstream

2. B

   Central nervous system and sinus

3. C

   Integumentary system and joints

4. D

   Genitourinary system and respiratory system

Appeared in: NORCET-11 Prelims

Explanation

• Candida most commonly involves the gastrointestinal tract and bloodstream in immunocompromised children.
• Candidemia and GI colonization are frequent due to mucosal barrier injury and central venous catheters.
• Other sites (CNS, skin, GU, respiratory) are less commonly the initial or primary sites.

Why Other Options Were Wrong

• Option B: Central nervous system and sinus involvement is more typical of other fungal infections (e.g., cryptococcosis, aspergillosis) or advanced disseminated candidiasis, not the most common initial sites.
• Option C: Integumentary system and joints are rarely the primary sites of systemic candidiasis in immunocompromised children. Skin lesions may occur but are not the most common.
• Option D: Genitourinary and respiratory systems are not the most common initial sites for systemic candidiasis in children with ALL. GU involvement is more common in chronic or complicated cases.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Most common sites of systemic candidiasis in immunocompromised children to guide bedside assessment, documentation, and the next nursing action.
• Nurses must monitor for signs of candidemia (fever, sepsis, positive blood cultures) in children with ALL.
• Early recognition and treatment of GI and bloodstream Candida infection can prevent severe complications.
• What if? If a child with ALL develops neurological symptoms, CNS involvement should be considered, but it is less common than GI or blood involvement.

How to Approach the Question

• Identify the underlying risk (immunocompromised child with ALL).
• Recall the most common sites of Candida infection in this population.
• Eliminate options that are less likely to be primary or initial sites.
• Focus on the pathophysiology: GI tract colonization and bloodstream invasion are most frequent.
• Use clinical reasoning to match the scenario to the most likely answer.

Concept Tested & Keywords

• Concept Tested: Most common sites of systemic candidiasis in immunocompromised children
• Stem keywords: acute lymphoblastic leukemia, systemic candidiasis, child
• Lead-in keywords: most commonly involved
• Clinical cues: immunocompromised state increases risk for GI and bloodstream Candida infection

Question ID

Qx1qe1CvF286BRKec8gztN

Copy ID

Reference Book

E6 Medicine Davidson Principles Practice 24e p. 322-324

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1929-1931