[Disseminated histoplasmosis in children]

Area of Science:

• Pediatric Infectious Diseases
• Mycology
• Public Health

Background:

• Disseminated histoplasmosis is a serious fungal infection, particularly in immunocompromised populations.
• Children, especially infants and those with severe malnutrition, are at high risk for severe forms of the disease.
• High mortality rates have been reported, necessitating a better understanding of clinical features and treatment efficacy.

Purpose of the Study:

• To evaluate the clinical features and treatment outcomes of disseminated histoplasmosis in a cohort of 38 children.
• To identify risk factors associated with severe disease and high lethality.
• To emphasize the importance of specific antifungal treatment, particularly amphotericin B.

Main Methods:

• Retrospective analysis of clinical data from 38 pediatric patients diagnosed with disseminated histoplasmosis.
• Review of patient demographics, clinical presentations, nutritional status, treatment regimens, and outcomes.
• Correlation of treatment duration and type with patient survival.

Main Results:

• The study included 38 children; 36 presented with severe disseminated histoplasmosis and 2 with mild chronic type.
• Infants (65%) and children with severe malnutrition (68%) showed a higher incidence.
• Overall lethality was 61%, with deaths linked to delayed or inadequate amphotericin B treatment (less than 15 days).

Conclusions:

• Disseminated histoplasmosis in children, particularly infants and malnourished individuals, is associated with severe morbidity and high mortality.
• Inadequate or delayed treatment with amphotericin B significantly increases the risk of death.
• Timely and appropriate amphotericin B therapy is critical for improving survival rates in pediatric disseminated histoplasmosis.