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Invasive mould infection in children - advances made or obstacles remaining?
Daniel K Yeoh1, Coen Butters2, Julia E Clark3
1Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia; Infection, Immunity and Global Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
Summary
Invasive mould infections (IMI) in immunocompromised children have poor outcomes. Advances in diagnostics and novel antifungals offer hope, but require more pediatric data for effective implementation.
Area of Science:
- Pediatric Infectious Diseases
- Medical Mycology
- Clinical Diagnostics
Background:
- Invasive mould infections (IMI) are a significant cause of illness and death in immunocompromised children.
- Current diagnostic tools and treatments for pediatric IMI have limitations, contributing to poor patient outcomes.
Purpose of the Study:
- To review current and emerging methods for diagnosing and treating IMI in immunocompromised children.
- Focus on recent advancements and persistent challenges in pediatric IMI management.
Main Methods:
- Comprehensive literature search of PubMed for diagnostic and management tools for pediatric IMI.
- Inclusion of clinical studies, preclinical research, consensus guidelines, and reviews.
Main Results:
- Diagnostic imaging like CT scans lack specificity; molecular assays and biomarkers show promise but need more pediatric data.
- Novel antifungal agents (e.g., isavuconazole) and immunotherapies are emerging, yet require specific pediatric clinical trial data.
- Traditional methods like cultures and histology remain crucial but have limitations in sensitivity and turnaround time.
Conclusions:
- Significant progress has been made in IMI management through new diagnostic techniques, antifungal drugs, and immunotherapies.
- Further pediatric studies are essential to guide the optimal clinical use of these advancements in treating invasive mould infections.
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