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Fungal lung disease.

Georgia Koltsida1, Theoklis Zaoutis2

  • 1Department of Pediatrics, National and Kapodistrian University of Athens, School of Medicine, Aghia Sophia Childrens Hospital, Greece.

Paediatric Respiratory Reviews
|June 13, 2020
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Summary

Pediatric fungal lung infections present differently in immunocompetent, immunocompromised, and cystic fibrosis patients. Fungal respiratory infections are increasingly common and severe in immunocompromised children.

Keywords:
Cystic fibrosisFungusImmunocompetentImmunocompromised

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Area of Science:

  • Pediatric Pulmonology
  • Medical Mycology
  • Infectious Diseases

Background:

  • Fungal lung disease in children exhibits unique characteristics across different patient groups, including immunocompetent, immunocompromised, and cystic fibrosis populations.
  • Pulmonary mycoses are less common in immunocompetent children, with endemic mycoses and Aspergillomas being the most frequent diagnoses.
  • Recent years have seen a rise in filamentous fungi, such as Aspergillus and Scedosporium, isolated from the respiratory secretions of individuals with cystic fibrosis.

Purpose of the Study:

  • To review the distinct presentations and increasing prevalence of fungal lung diseases in pediatric populations.
  • To highlight the specific challenges posed by fungal infections in immunocompromised children and those with cystic fibrosis.

Main Methods:

  • Literature review focusing on pediatric fungal respiratory infections.
  • Analysis of prevalence and etiological agents in different pediatric subgroups.
  • Synthesis of current understanding regarding risk factors and clinical manifestations.

Main Results:

  • Fungal lung diseases manifest differently in immunocompetent, immunocompromised, and cystic fibrosis pediatric patients.
  • Filamentous fungi like Aspergillus and Scedosporium are increasingly identified in cystic fibrosis patients.
  • Fungal respiratory infections are more frequent and severe in immunocompromised children, including those with malignancies, transplant recipients, and primary immunodeficiencies.

Conclusions:

  • Fungal lung infections in children require tailored diagnostic and therapeutic approaches based on immune status and underlying conditions.
  • Increased vigilance is necessary for identifying and managing fungal respiratory pathogens, particularly in vulnerable pediatric populations.
  • Further research is warranted to understand the evolving epidemiology and optimize treatment strategies for pediatric pulmonary mycoses.