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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
|September 17, 2009
PubMed

Insights

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.

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.

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