Blastomycosis in children

Area of Science:

• Mycology
• Pediatric Infectious Diseases
• Pulmonology

Background:

• Blastomycosis is a fungal infection primarily affecting the lungs.
• Children are susceptible, especially those in or traveling to endemic regions.
• Infection is typically acquired through respiratory inhalation of fungal spores.

Purpose of the Study:

• To summarize the clinical presentation, diagnosis, and treatment of blastomycosis in children.
• To highlight key differences in presentation and dissemination between pediatric and adult cases.
• To inform clinicians on diagnostic and therapeutic strategies for pediatric blastomycosis.

Main Methods:

• Review of existing literature on pediatric blastomycosis.
• Analysis of clinical symptoms, diagnostic methods, and treatment outcomes.
• Comparison of disease patterns in children versus adults and in different epidemiological settings.

Main Results:

• Many pediatric cases are asymptomatic or present with non-specific respiratory symptoms mimicking common infections.
• Extrapulmonary dissemination is more frequently reported in children than in adults, particularly in chronic or non-outbreak cases.
• Chest radiography may show infiltrates, consolidation, nodules, or cavitation.
• Diagnosis is suspected based on persistent symptoms, endemic exposure, and imaging findings, confirmed by microscopy and culture.
• Amphotericin B is the primary effective treatment, with limited data on oral azoles in children.

Conclusions:

• Pediatric blastomycosis requires a high index of suspicion, especially with persistent respiratory symptoms and relevant travel/residence history.
• Prompt diagnosis and treatment, often with Amphotericin B, are crucial for favorable outcomes.
• Further research on long-term outcomes and alternative treatments in children is warranted.