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Pulmonary function following blastomycosis in childhood
1Department of Pediatrics and Child Health, University of Manitoba, Children's Hospital of Winnipeg, Canada.
Insights
Most children recover normal lung function after childhood blastomycosis. Severe initial disease and slow recovery may indicate long-term pulmonary sequelae in pediatric blastomycosis patients.
Area of Science:
- Infectious Diseases
- Pulmonology
- Pediatrics
Background:
- Blastomycosis is a fungal infection that can affect the lungs.
- Pediatric blastomycosis requires understanding long-term pulmonary outcomes.
- Assessing sequelae is crucial for managing childhood infections.
Purpose of the Study:
- To determine the pulmonary outcome in children after blastomycosis.
- To evaluate long-term pulmonary function in pediatric blastomycosis survivors.
Main Methods:
- Retrospective case series of hospitalized pediatric blastomycosis patients.
- Pulmonary function testing (PFT) recall for a subset of patients.
- Prospective PFT in three recently hospitalized children.
Main Results:
- Most patients (5/5) had normal PFT at follow-up, a mean of 4.5 years post-diagnosis.
- Two patients with severe initial disease showed persistent pulmonary sequelae.
- Prospective follow-up identified those with more severe initial presentations.
Conclusions:
- Pediatric pulmonary blastomycosis typically resolves with normal lung function.
- Severe initial presentation and prolonged recovery predict potential long-term pulmonary sequelae.
- Long-term PFT monitoring may be beneficial for select pediatric cases.
Abstract:
In order to determine the pulmonary outcome following blastomycosis during childhood, we compiled a case series of hospitalized patients from a retrospective review with later recall for pulmonary function testing, coupled with prospective measurements of pulmonary function in three patients, at a tertiary care children's hospital. A convenience sample of five of 17 patients hospitalized with pulmonary blastomycosis, whose mean age at the time of diagnosis was 10.6 +/- 5.5 years, was recalled at a mean of 4.5 +/- 3.5 years after diagnosis. Three patients more recently hospitalized underwent serial pulmonary function testing (PFT) prospectively from as soon after the acute infection as their condition permitted. All but two patients had normal PFT when last seen. The two patients with persistent pulmonary sequelae were among those followed up prospectively and had more severe clinical and radiographic pictures at the outset. Pulmonary function in children who suffered from pulmonary blastomycosis is normal in most patients at follow-up years later. Severe radiographic disease and slow recovery over months portend long-term sequelae.