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Community-acquired fungal pneumonia in children
1Department of Pediatrics, Arkansas Children's Hospital, Little Rock 72202, USA.
Abstract:
Pediatric fungal pulmonary infections are being seen with increasing frequency. The dimorphic fungi Histoplasma capsulatum. Blastomyces dermatitidis, Coccidioides immitis, and Cryptococcus neoformans frequently cause infections that are asymptomatic. However, patients may suffer pneumonia and disseminated disease. Diagnosis can be made definitively by isolation of the causative organism, but serology or skin testing is often necessary when this is not successful. Severe or life threatening infections are treated with amphotericin B. Recently, new oral azole antifungals are being used more frequently for mild to moderate disease with good success.
Insights
Pediatric fungal pulmonary infections, caused by dimorphic fungi, are increasing. Diagnosis involves organism isolation, serology, or skin testing, with treatment ranging from amphotericin B to newer oral azoles for milder cases.
Area of Science:
- Medical Mycology
- Pediatric Infectious Diseases
- Pulmonology
Background:
- Pediatric fungal pulmonary infections are increasingly prevalent.
- Common causative agents include dimorphic fungi like Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis, and Cryptococcus neoformans.
- Infections can range from asymptomatic to severe pneumonia and disseminated disease.
Purpose of the Study:
- To review the diagnosis and management of pediatric fungal pulmonary infections.
- To highlight the spectrum of clinical presentations and causative organisms.
- To discuss current and emerging treatment strategies.
Main Methods:
- Literature review of pediatric fungal pulmonary infections.
- Analysis of diagnostic approaches including organism isolation, serology, and skin testing.
- Evaluation of therapeutic options, including traditional and novel antifungal agents.
Main Results:
- Dimorphic fungi frequently cause asymptomatic infections but can lead to pneumonia and disseminated disease in children.
- Definitive diagnosis often requires organism isolation, though serology and skin testing are valuable alternatives.
- Severe infections are treated with amphotericin B, while mild to moderate cases show success with newer oral azole antifungals.
Conclusions:
- Prompt and accurate diagnosis is crucial for effective management of pediatric fungal lung infections.
- Treatment strategies should be tailored to disease severity, utilizing both established and emerging antifungal therapies.
- Increased awareness and diagnostic capabilities are essential given the rising incidence of these infections.