Systemic candidiasis with acute Epstein-Barr virus infection

Area of Science:

• Infectious Diseases
• Pediatrics
• Mycology

Background:

• Systemic Candida infections are opportunistic, primarily affecting immunocompromised individuals.
• Invasive non-albicans Candida infections are rare in healthy children.
• Epstein-Barr virus (EBV) infection typically does not cause clinically significant immunosuppression.

Observation:

• Two previously healthy male children, aged 2 and 9 years, presented with invasive Candida infections.
• One child had sepsis due to Candida species, while the other experienced sepsis and arthritis due to Candida parapsilosis.
• Both children had concurrent acute Epstein-Barr virus infection, confirmed serologically.

Findings:

• This report details the first known cases of invasive non-albicans Candida infection complicating Epstein-Barr virus infection in previously healthy children.
• Diagnosis was confirmed via blood cultures for Candida species.
• Both patients achieved a complete cure following antifungal treatment with fluconazole.

Implications:

• These cases suggest a potential, previously unreported association between Epstein-Barr virus infection and invasive Candida infections in pediatric populations.
• Highlights the importance of considering invasive fungal infections even in seemingly healthy children presenting with sepsis or arthritis, especially if concurrent viral infections are present.
• Further research is warranted to elucidate the potential mechanisms linking EBV infection and invasive candidiasis in children.