Clinical and diagnostic pathways in pediatric fungal infections

Elio Castagnola

DOI: https://doi.org/10.7175/rhc.v4i1S.859

Abstract

Generally speaking, in pediatrics the patients mostly affected by fungal infections are hematological patients, followed by those with solid tumors, and transplant recipients. Candida infections generally occur just after birth, whereas Aspergillus infections are age-related, and increase their incidence with age. However, among infections, the incidence of bacteremias are still greater than that of mycoses. In pediatrics, in Italy the immunocompromised patients – thus particularly susceptible to fungal infections – are mainly those with severe combined immunodeficiency, chronic mucocutaneous candidiasis, and chronic granulomatous disease. Particular Aspergillus or Scedosporium infections should be considered in peculiar kinds of patients, such as those affected by cystic fibrosis. Finally, different kinds of fungi should be considered in those who come from or spend a lot time in specific areas, such as South America (e.g. coccidioidomycoses, for which differential diagnosis is with tuberculosis).

Keywords

Fungal infections; Children; Risk factors; Underlying pathologies; Oncology; Leukemia

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References

  • Steinbach WJ, Roilides E, Berman D, et al; and the International Pediatric Fungal Network. Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates. Pediatr Infect Dis J 2012; 31: 1252-7; http://dx.doi.org/10.1097/INF.0b013e3182737427
  • Groll A, Castagnola E, Cesaro S, et al. ECIL 4 – Pediatric Group Considerations for Fungal Diseases and Antifungal Treatment in Children. Disponibile all’indirizzo http://www.ebmt.org/Contents/Resources/Library/ECIL/Documents/ECIL%204%202011%20Paediatric%20guidelines%20Fungi%20and%20antifungals.pdf (ultimo accesso gennaio 2013)
  • Castagnola E, Bagnasco F, Faraci M, et al. Incidence of bacteremias and invasive mycoses in children undergoing allogeneic hematopoietic stem cell transplantation: a single center experience. Bone Marrow Transplant 2008; 41: 339-47; http://dx.doi.org/10.1038/sj.bmt.1705921

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