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Cryptococcosis in human immunodeficiency virus-infected children
C E Gonzalez1, D Shetty, L L Lewis
1Infectious Diseases Section, National Cancer Institute, Bethesda, MD 20892, USA.
The Pediatric Infectious Disease Journal
|September 1, 1996
Summary
Cryptococcosis is a rare but treatable opportunistic infection in children with advanced Human Immunodeficiency Virus (HIV) infection. Early diagnosis and treatment of this fungal infection are crucial for a positive outcome in pediatric AIDS patients.
Area of Science:
- Pediatric Infectious Diseases
- Immunocompromised Hosts
- Opportunistic Infections
Background:
- Cryptococcosis is a significant opportunistic infection in adults with Acquired Immunodeficiency Syndrome (AIDS).
- Limited data exists on cryptococcosis in pediatric AIDS cases, particularly regarding epidemiology, clinical features, and outcomes.
- This study addresses the lack of comprehensive research on cryptococcosis in a large cohort of HIV-infected children.
Purpose of the Study:
- To describe the epidemiology, clinical manifestations, and outcomes of cryptococcosis in HIV-infected children.
- To highlight the importance of considering cryptococcosis in the differential diagnosis of febrile illnesses in this population.
Main Methods:
- A retrospective review of hospital records was conducted for 473 HIV-infected children monitored between 1987 and 1995.
- Cases of cryptococcosis were identified and analyzed for demographic, clinical, and treatment data.
Main Results:
- Four (0.85%) children developed cryptococcosis, all with severe CD4+ T-cell depletion and prior opportunistic infections.
- The infection presented as disseminated disease or localized lung involvement, with intermittent fever as the most common symptom.
- All patients had positive serum cryptococcal antigen, and all survived the infection with appropriate antifungal therapy, including amphotericin B and fluconazole.
Conclusions:
- Cryptococcosis is an uncommon but treatable opportunistic infection in advanced pediatric AIDS.
- Subtle clinical manifestations can occur, necessitating careful evaluation in febrile HIV-infected children.
- Prompt diagnosis and management are essential for favorable outcomes in pediatric cryptococcosis.