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Deep cutaneous fungal infections in immunocompromised children

Danielle Marcoux1, Fatemeh Jafarian, Valérie Joncas

  • 1Division of Dermatology, CHU Sainte-Justine, Montreal, Quebec, Canada. danmarcoux@videotron.ca

Journal of the American Academy of Dermatology
|September 15, 2009
PubMed
Abstract

Insights

Deep cutaneous fungal infections (DCFI) are a growing concern in immunocompromised children, often presenting with skin lesions. Early diagnosis and treatment are critical to reduce high mortality rates associated with these fungal infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Dermatology

Background:

  • Life-threatening fungal infections are increasing in children due to immunosuppression and broad-spectrum antibiotics.
  • Premature neonates and individuals with compromised skin barriers are at higher risk.
  • Delayed diagnosis of deep cutaneous fungal infections (DCFI) leads to high mortality.

Purpose of the Study:

  • To characterize pediatric patients diagnosed with DCFI.
  • To identify the fungi responsible for DCFI in children.
  • To determine the risk factors associated with DCFI in pediatric cases.

Main Methods:

  • Retrospective medical record review of pediatric patients with DCFI from 1980-2008.
  • Data collected from institutional pathology and microbiology databases.
  • Analysis of patient demographics, clinical presentation, causative fungi, and treatment outcomes.

Main Results:

  • Twenty-six immunocompromised children (mean age 8 years) with DCFI were identified, predominantly with hematologic disorders.
  • Common clinical presentations included necrotic ulcers (42%) and papules (34%).
  • Aspergillus (44%) and Candida (33%) were the most common fungal pathogens identified; 77% of patients recovered, while 23% died.

Conclusions:

  • DCFI must be considered in the differential diagnosis of skin lesions in immunocompromised children.
  • Prompt skin biopsies for histopathology and fungal culture are essential for early diagnosis.
  • Timely treatment is crucial to improve survival rates in pediatric DCFI cases.

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