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Zygomycosis in children: a systematic review and analysis of reported cases

Theoklis E Zaoutis1, Emmanuel Roilides, Christine C Chiou

  • 1Department of Pediatrics and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. zaoutis@email.chop.edu

The Pediatric Infectious Disease Journal
|September 13, 2007
PubMed

Insights

Pediatric zygomycosis is a severe fungal infection with high mortality, particularly in infants and those with underlying conditions like neutropenia or diabetes. Early treatment with amphotericin B and surgery significantly improves survival rates.

Area of Science:

  • Mycology
  • Pediatric Infectious Diseases
  • Epidemiology

Background:

  • Zygomycosis presents a significant and increasing threat, especially to immunocompromised individuals, carrying a high mortality rate.
  • Comprehensive analyses of pediatric zygomycosis cases remain scarce in published literature.

Purpose of the Study:

  • To conduct a thorough analysis of pediatric zygomycosis cases.
  • To identify risk factors, common clinical presentations, and outcomes in children with zygomycosis.

Main Methods:

  • A systematic PubMed search was performed for English-language publications on pediatric zygomycosis (ages 0-18).
  • References from major textbooks and individual case reports/series were reviewed to identify additional cases.
  • Data were compiled in a database and analyzed using logistic regression.

Main Results:

  • 157 pediatric cases were identified, with neutropenia, prematurity, and diabetes mellitus as common predisposing factors.
  • Cutaneous, gastrointestinal, rhinocerebral, and pulmonary zygomycosis were the most frequent forms; Rhizopus and Mucor species were the most common pathogens.
  • Mortality was significantly higher in untreated patients (88% vs. 36%), with disseminated infection and age under 1 year identified as independent risk factors for death. Antifungal therapy and surgery substantially reduced mortality.

Conclusions:

  • Zygomycosis is a life-threatening pediatric infection, often associated with neutropenia, diabetes mellitus, and prematurity.
  • Disseminated disease, lack of treatment, and infancy (<1 year) are linked to poor outcomes.
  • Amphotericin B treatment and surgical intervention are critical for improving survival in pediatric zygomycosis.
Abstract

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