Rare Fungal Infections in Children: An Updated Review of the Literature

Pana, Zoi Dorothea; Vikelouda, Katerina; Roilides, Emmanuel

doi:10.1007/s12281-014-0175-0

Cited by 5 publications

(3 citation statements)

References 94 publications

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“…The spectrum of pediatric patients vulnerable to IFD is wide and includes children who receive chemotherapy for a malignancy, pediatric hematopoietic stem cell transplantation (HCT) or solid organ transplant (SOT) recipients, children with a primary immunodeficiency (PID), children who receive immunomodulating therapy for an autoimmune condition, and those with an acquired immunodeficiency. Beyond these patient groups, neonates and children hospitalized in an intensive care unit (ICU), among other groups, are also at risk for IFD [5][6][7][8][9][10].…”

mentioning

confidence: 99%

Epidemiology of Invasive Fungal Disease in Children

Pana

Roilides

Warris

et al. 2017

Journal of the Pediatric Infectious Diseases Society

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Considerable progress has been made in the prevention, diagnosis, and management of pediatric patients with invasive fungal disease (IFD). The reported decreasing trend in the incidence of invasive candidiasis (IC) over the past 15 years in both neonates and children has been encouraging. Nevertheless, due to the growing number of immunocompromised children at risk for IFD, this disease continues to be associated with significant morbidity and death and with increased financial burden to the health care system. Therefore, it is important to understand the contemporary epidemiology of IFD. Incidence rates of IFD in children are affected by geographical, population, and time variability. There is an ongoing effort to constantly document and update the incidence of IFD and species distribution among different pediatric populations as a means to direct preventative, diagnostic, and therapeutic resources to the most appropriate subset of patients. Children with a hematologic malignancy or a primary or secondary immunodeficiency, those undergoing solid organ or hematopoietic stem cell transplantation, and premature neonates are the major subsets of pediatric patients at risk of developing IFD. In this review, we focus on fungal disease epidemiology with a specific emphasis on the 2 most common pediatric IFDs, IC and invasive aspergillosis (IA).

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confidence: 99%

Epidemiology of Invasive Fungal Disease in Children

Pana

Roilides

Warris

et al. 2017

Journal of the Pediatric Infectious Diseases Society

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150

122

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“…Amphotericin B lipid complex at 5 mg/kg/d can be also used [13]. Other indications for AMB administration in children include blastomycosis, coccidioidomycosis, histoplasmosis, and endemic mycoses, whereas LAMB at a higher dose (≥5 mg/kg) is the first-line treatment of mucormycosis [13,14]. The combination of LAMB with flucytosine is proposed to treat difficult fungal infections, such as Candida meningitis and endocarditis [15].…”

Section: Prophylaxis Empiric Therapy and Targeted Antifungal Thementioning

confidence: 99%

“…A number of rarer IFIs may be encountered in immunocompromised children—such as invasive fusariosis, scedosporiosis, or trichosporonosis. A review of these infections in children has been published [139]. Antifungal therapy for them in infants or children does not differ from that in adults even though some of the active agents (such as voriconazole) cannot be given in young patients.…”

Section: Prophylaxis Empiric Therapy and Targeted Antifungal Thementioning

confidence: 99%

Advances in the Treatment of Mycoses in Pediatric Patients

Iosifidis

Papachristou

Roilides

2018

JoF

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The main indications for antifungal drug administration in pediatrics are reviewed as well as an update of the data of antifungal agents and antifungal policies performed. Specifically, antifungal therapy in three main areas is updated as follows: a) Prophylaxis of premature neonates against invasive candidiasis; b) management of candidemia and meningoencephalitis in neonates; and c) prophylaxis, empiric therapy, and targeted antifungal therapy in children with primary or secondary immunodeficiencies. Fluconazole remains the most frequent antifungal prophylactic agent given to high-risk neonates and children. However, the emergence of fluconazole resistance, particularly in non-albicans Candida species, should be considered during preventive or empiric therapy. In very-low birth-weight neonates, although fluconazole is used as antifungal prophylaxis in neonatal intensive care units (NICU’s) with relatively high incidence of invasive candidiasis (IC), its role is under continuous debate. Amphotericin B, primarily in its liposomal formulation, remains the mainstay of therapy for treating neonatal and pediatric yeast and mold infections. Voriconazole is indicated for mold infections except for mucormycosis in children >2 years. Newer triazoles-such as posaconazole and isavuconazole-as well as echinocandins, are either licensed or under study for first-line or salvage therapy, whereas combination therapy is kept for refractory cases.

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