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Chronic Disseminated Candidiasis in Children and the Role of Corticosteroids Therapy

Laila S Al Yazidi1, Nagi Elsidig1, Yasser Wali1

  • 1From the Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.

The Pediatric Infectious Disease Journal
|February 16, 2023
PubMed

Insights

Chronic disseminated candidiasis (CDC) in children, particularly those with acute leukemia, is described. Corticosteroids appear effective and safe for managing immune reconstitution inflammatory syndrome (IRIS) complicating CDC in pediatric patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Immunocompromised Host Management

Background:

  • Limited data exists on chronic disseminated candidiasis (CDC) in children.
  • This study characterizes CDC epidemiology, risk factors, and outcomes in pediatric patients at Sultan Qaboos University Hospital.
  • The role of corticosteroids in managing immune reconstitution inflammatory syndrome (IRIS) complicating CDC in children is explored.

Approach:

  • Retrospective analysis of demographic, clinical, and laboratory data for pediatric CDC cases (2013-2021).
  • Literature review on corticosteroid use for CDC-related IRIS in children since 2005.
  • Focus on patients with invasive fungal infections, specifically those diagnosed with CDC.

Key Points:

  • Six pediatric cases of CDC were identified, all with acute leukemia; median age was 5.75 years.
  • Common clinical features included prolonged fever and skin rash; Candida tropicalis was frequently isolated.
  • CDC-related IRIS occurred in 83% of cases, with corticosteroids showing efficacy and safety.

Conclusions:

  • Chronic disseminated candidiasis is more prevalent in pediatric acute leukemia.
  • Immune reconstitution inflammatory syndrome is a significant complication of CDC in children.
  • Corticosteroid therapy is a potentially effective and safe adjunctive treatment for CDC-related IRIS in pediatric populations.
Abstract

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