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Paediatric Histoplasmosis 2000-2019: A Review of 83 Cases
Rebecca MacInnes1, Adilia Warris1,2
1Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK.
Abstract:
Histoplasmosis is an endemic fungal infection that is confined to specific geographical regions. Histoplasma spp. are primary pathogens that cause disease in both immunocompetent and immunocompromised patients, ranging from a single-organ (mostly affecting the lungs) infection to life-threatening disseminated disease. Knowledge about the clinical epidemiology relies on data from adult populations; little is known about the patient and disease characteristics in the paediatric population. Therefore, a structured review of published cases of paediatric histoplasmosis between 2000 and 2019 was performed. A literature search of PubMed was conducted and the epidemiological and clinical data from 83 cases were analysed. The mean age at presentation was 9.5 ± 5.5 years, and 51% were girls. Two-thirds of the children were immunocompromised. The majority of children presented with disseminated disease. The most frequently observed clinical symptoms were respiratory symptoms, alongside non-specific systemic features, including fever, myalgia, fatigue and weight loss. The mortality rate was 11%. Histoplasmosis affects children of any age. Being immunocompromised is a risk factor for severe and disseminated disease. The lack of specific presenting features leads to underreporting and delay in diagnosis. To improve the recognition and outcome of histoplasmosis in childhood, increased awareness and surveillance systems are warranted.
Insights
Pediatric histoplasmosis, a fungal infection, often presents with disseminated disease, especially in immunocompromised children. Increased awareness and surveillance are crucial for early diagnosis and improved outcomes in children.
Area of Science:
- Mycology
- Infectious Diseases
- Pediatrics
Background:
- Histoplasmosis is an endemic fungal infection caused by *Histoplasma* spp.
- It affects both immunocompetent and immunocompromised individuals, ranging from localized to disseminated disease.
- Limited data exists on the clinical epidemiology of histoplasmosis in pediatric populations.
Purpose of the Study:
- To review and analyze published cases of pediatric histoplasmosis between 2000 and 2019.
- To describe patient and disease characteristics in children with histoplasmosis.
- To highlight the need for improved recognition and surveillance of childhood histoplasmosis.
Main Methods:
- A structured literature review was performed.
- PubMed was searched for published cases of pediatric histoplasmosis from 2000-2019.
- Epidemiological and clinical data from 83 cases were analyzed.
Main Results:
- The study analyzed 83 cases of pediatric histoplasmosis.
- The mean age was 9.5 years, with 51% being girls.
- Two-thirds of children were immunocompromised, and most presented with disseminated disease.
- Common symptoms included respiratory issues, fever, myalgia, fatigue, and weight loss.
- The overall mortality rate was 11%.
Conclusions:
- Histoplasmosis affects children of all ages, with immunocompromise being a risk factor for severe, disseminated disease.
- Non-specific symptoms and lack of specific features contribute to delayed diagnosis.
- Enhanced awareness and surveillance are necessary to improve recognition and outcomes in pediatric histoplasmosis.
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