Cryptococcal infections in children: retrospective study and review from Australia

Area of Science:

• Medical Mycology
• Pediatric Infectious Diseases
• Epidemiology

Background:

• Cryptococcosis presents a global health challenge with considerable morbidity and mortality.
• Limited data exist regarding the epidemiology and clinical outcomes of cryptococcosis in pediatric populations.

Purpose of the Study:

• To investigate the incidence, clinical characteristics, and outcomes of cryptococcosis in Australian children.
• To review existing literature and conduct a network audit of pediatric cases.

Main Methods:

• A retrospective literature review identified Australian pediatric cryptococcosis cases.
• A 10-year audit of cases from a major pediatric network was performed.
• Data analysis focused on patient demographics, clinical presentation, causative species, treatment, and outcomes.

Main Results:

• Twenty-two pediatric cases were identified through literature review, with a median age of 13.5 years; 82% had meningitis or CNS infection, and 61% of reported outcomes were fatal.
• In a 2008-2017 audit, five of six pediatric cases involved Cryptococcus gattii and survived; one child with acute lymphoblastic leukemia and Cryptococcus neoformans infection died.
• Among survivors, 67% experienced persistent neurological or respiratory sequelae.

Conclusions:

• Cryptococcosis is an infrequent but severe infection in Australian children.
• The condition is associated with significant morbidity, including neurological and respiratory complications.
• Prompt diagnosis and management are crucial for improving outcomes in pediatric cryptococcosis.