[A clinical study of invasive fungal disease in children without underlying diseases]

Area of Science:

• Pediatric Infectious Diseases
• Mycology
• Clinical Medicine

Background:

• Invasive fungal disease (IFD) typically affects immunocompromised individuals.
• Understanding IFD in immunocompetent children is crucial for accurate diagnosis and treatment.
• This study focuses on the clinical characteristics of IFD in children without prior health issues.

Purpose of the Study:

• To investigate the clinical features of invasive fungal disease (IFD) in children without underlying diseases.
• To identify common fungal pathogens and clinical presentations of IFD in this population.
• To evaluate the risk factors and treatment outcomes for IFD in healthy children.

Main Methods:

• Retrospective analysis of clinical data from 49 children diagnosed with IFD.
• Identification of fungal pathogens, including Cryptococcus neoformans, Candida albicans, Aspergillus, and Candida parapsilosis.
• Assessment of clinical features, risk factors (antibiotic use, prolonged hospitalization, invasive procedures), treatment response, and outcomes.

Main Results:

• Fungal pathogens were detected in 76% of patients, with Cryptococcus neoformans (46%) and Candida albicans (27%) being predominant.
• Fungal pneumonia was the most frequent diagnosis (46%), often associated with Candida albicans.
• High-risk factors included antibiotic use and prolonged hospital stays; 82% showed poor response to antibiotics.
• Antifungal therapy led to a cure in 75% of cases, with a 10% mortality rate.

Conclusions:

• Cryptococcus neoformans and Candida species are the primary pathogens causing IFD in children without underlying diseases.
• Fungal pneumonia is the most common clinical manifestation.
• Prolonged high-dose antibiotic use may be a significant risk factor for IFD in this population.
• Children without underlying diseases demonstrate sensitivity to antifungal drugs, resulting in a favorable prognosis.