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Macrophage Cholesterol Depletion and Its Effect on the Phagocytosis of Cryptococcus neoformans
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Pediatric Cryptococcosis.

Alison Gifford1, Naamal Jayawardena1, Fabianne Carlesse2,3

  • 1MRC Centre for Medical Mycology, University of Exeter, Exeter, United Kingdom.

The Pediatric Infectious Disease Journal
|January 19, 2024
PubMed
Summary
This summary is machine-generated.

Cryptococcosis in children, particularly those with HIV, presents unique challenges. This review highlights varied clinical signs, outcomes, and treatment disparities, emphasizing the need for further research.

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Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Epidemiology

Background:

  • Cryptococcus is a common cause of meningitis in HIV-infected individuals, yet pediatric disease is underreported.
  • Seroprevalence indicates widespread exposure in children, contrasting with lower reported disease incidence.

Purpose of the Study:

  • To conduct a comprehensive review of pediatric cryptococcosis.
  • To analyze clinical presentation, outcomes, and treatment patterns based on immune status.

Main Methods:

  • Systematic literature search of PubMed and Ovid Global Health databases.
  • Inclusion of English-language studies reporting pediatric data from 1980 to December 2022.
  • Review of 168 publications encompassing 1469 children.

Main Results:

  • Majority of cases (54.2%) reported from Africa; 65% of children were HIV-positive.
  • Fever, headache, and vomiting were common symptoms; 80% had meningoencephalitis.
  • Lung involvement varied by immune status; only 22% received recommended combination antifungal therapy.
  • Overall mortality was 23%, with higher rates in HIV-positive children.

Conclusions:

  • This review is the largest on pediatric cryptococcosis, revealing distinct clinical features and outcomes.
  • Significant disparities in treatment and outcomes exist based on underlying conditions, especially HIV.
  • Urgent need for prospective studies to improve understanding and management of pediatric cryptococcosis.