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Invasive zygomycosis in neonates and children.

E Roilides1, T E Zaoutis, T J Walsh

  • 13rd Department of Paediatrics, Aristotle University, Thessaloniki, Greece. roilides@med.auth.gr

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
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Invasive zygomycosis presents differently in neonates and children compared to adults, with gastrointestinal and cutaneous forms being most common. Early antifungal therapy and surgery improve survival rates for this life-threatening fungal infection.

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Area of Science:

  • Mycology
  • Pediatric Infectious Diseases
  • Neonatology

Background:

  • Invasive zygomycosis, a serious fungal infection, affects neonates and children differently than adults.
  • Understanding age-specific patterns is crucial for diagnosis and treatment.

Purpose of the Study:

  • To compare invasive zygomycosis in neonates and children with adult cases.
  • To identify risk factors and effective management strategies.

Main Methods:

  • Systematic literature review of PubMed and reference lists for English-language case reports and series.
  • Inclusion criteria for neonatal (<1 month) and pediatric (<=18 years) cases.
  • Comparison of findings with published adult zygomycosis data.

Main Results:

  • 59 neonatal and 187 pediatric cases were analyzed.
  • Gastrointestinal (54%) and cutaneous (36%) zygomycosis were most common in neonates, differing from adult sinopulmonary/rhinocerebral patterns.
  • Mortality rates were high: 64% in neonates, 56% in children, and 53% in adults. Dissemination and young age (<1 year) were independent risk factors for death in children.

Conclusions:

  • Zygomycosis is a life-threatening infection in pediatric populations with distinct clinical presentations.
  • Combination therapy with amphotericin B and surgery demonstrated protective effects against mortality.
  • Prompt diagnosis and aggressive management are essential for improving outcomes in neonates and children.