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Cryptococcosis in children with AIDS
J Abadi1, S Nachman, A B Kressel
1Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Insights
Cryptococcus neoformans infections in children with human immunodeficiency virus (HIV) are similar to adults. This study estimated a 1% prevalence of cryptococcosis in children with acquired immunodeficiency syndrome (AIDS).
Area of Science:
- Pediatric Infectious Diseases
- Mycology
- Immunocompromised Hosts
Background:
- Cryptococcus neoformans is an opportunistic fungal pathogen.
- Infections are a significant concern in individuals with human immunodeficiency virus (HIV).
- Pediatric data on cryptococcosis, particularly in the context of HIV, is limited.
Purpose of the Study:
- To describe the clinical and immunologic features of Cryptococcus neoformans infections in HIV-infected children.
- To estimate the prevalence of cryptococcosis in pediatric acquired immunodeficiency syndrome (AIDS) patients.
Main Methods:
- Retrospective case series analysis.
- Inclusion criteria: patients diagnosed with cryptococcosis between 1985 and 1996.
- Data collected: clinical presentation, immunologic status (CD4+ cell count), and diagnostic methods (culture, antigen testing).
Main Results:
- Thirty cases of cryptococcosis were identified in HIV-infected children.
- Median age was 9.8 years with a median CD4+ cell count of 54/microL.
- 63% of cases occurred in vertically HIV-infected children aged 6-12 years; clinical/lab features mirrored adult cryptococcosis.
- Estimated 10-year point prevalence of cryptococcosis among children with AIDS was approximately 1%.
Conclusions:
- Pediatric HIV-associated cryptococcosis shares clinical and laboratory similarities with adult cases.
- The findings highlight the importance of considering cryptococcosis in immunocompromised children.
- A 1% prevalence suggests cryptococcosis is a notable opportunistic infection in this pediatric population.
Abstract:
We compiled the clinical and immunologic features of Cryptococcus neoformans infections in human immunodeficiency virus (HIV)-infected children from 1985 to 1996 in a retrospective case series. Thirty cases of cryptococcosis were identified. These children had a median age of 9.8 years, a median CD4+ cell count of 54/microL at the time of diagnosis, and either a culture positive for C. neoformans or cryptococcal antigen in serum or cerebrospinal fluid. Sixty-three percent of the cases occurred in children vertically infected with HIV and in children between 6 and 12 years of age. The clinical and laboratory characteristics of this pediatric cohort were similar to those of adults with AIDS and cryptococcosis. On the basis of a subset of the cases, a 10-year point prevalence of cryptococcosis among children with AIDS of approximately 1% was estimated.