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How different is invasive fusariosis in pediatric patients than in adults? A systematic review

Luana Rossato1, Fabianne Carlesse2,3, João Nobrega de Almeida1,4

  • 1Special Mycology Laboratory-LEMI, Division of Infectious Diseases, Department of Medicine, Federal University of São Paulo.

Current Opinion in Infectious Diseases
|November 9, 2021
PubMed

Insights

Invasive fusariosis (IF) in children often affects those with hematologic malignancies. Voriconazole therapy shows promise for treating IF in pediatric patients, despite pharmacokinetic variability.

Area of Science:

  • Mycology
  • Pediatric Infectious Diseases
  • Onco-hematology

Background:

  • Invasive fusariosis (IF) is a serious fungal infection, particularly in immunocompromised pediatric populations.
  • This review systematically examines IF cases in children to understand disease characteristics and treatment outcomes.

Observation:

  • A total of 106 pediatric cases of IF were analyzed, with hematologic malignancy identified in 64% of patients.
  • The most common sites of infection included skin (66%), blood (47%), and lungs (35%).
  • Fusarium solani and Fusarium oxysporum were the predominant species identified.

Findings:

  • Relapsed or refractory disease significantly correlated with poor outcomes in disseminated fusariosis (P < 0.001).
  • Voriconazole-based therapy was associated with a better prognosis (P = 0.04).
  • IF in children frequently involves organs beyond the skin, blood, and lungs, often in the context of intensive immunosuppression for hematologic malignancies or solid tumors.

Implications:

  • Understanding the specific vulnerabilities and common sites of IF in pediatric patients is crucial for early diagnosis and management.
  • Voriconazole demonstrates therapeutic potential in pediatric IF, warranting further investigation into optimized dosing strategies due to pharmacokinetic variability.
  • Effective management strategies for IF in immunocompromised children require a multidisciplinary approach, considering underlying conditions and targeted antifungal therapy.
Abstract

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