Opportunistic fungal infection in children and management.


Lam JM
Curr Opin Pediatr. 2018 Aug;30(4):514-519



An opportunistic mycosis is a fungal agent of low pathogenicity that specifically infects immunocompromised hosts. Advances in transplantation, preterm care, immunosuppressive therapies and intensive care, have lead to the emergence of pediatric patients with serious immunodeficiency who are vulnerable to nonpathogenic fungi.


The advent of the use of biologic agents in pediatric disease as well as the advances in care of preterm and immunosuppressed patients opens up a new cohort of patients at risk of opportunistic mycotic infections. Recent cases of cutaneous histioplasmosis as the presenting sign of hyper-IgM syndrome and the case of cutaneous blastomycosis in a patient treated with infliximab underscore the need to have a high clinical suspicion for deep fungal infections in immunosuppressed patients.


The current review will focus on the cutaneous manifestations of cutaneous infections by Aspergillus, Blastomyces, histoplasmosis, and mucormycosis. Greater understanding of these diseases and high-quality research in identification and treatment can enhance care of patients in the coming future.