Fungal infections in children

Roilides, E.

Author address: 

Aristotle University, Thessaloniki, Greece

Abstract: 

Invasive fungal infections (IFI) are not unusual in neonates, infants and children. High-risk pediatric patients are extremely low birth-weight premature neonates, patients with primary immunodeficiencies, patients with hematological malignancies, transplantation, and other secondary immunodeficiencies. In this meet-the-expert session, three different scenaria of IFI in high-risk pediatric patients are presented and discussed. A case of invasive candidosis in premature neonate, invasive pulmonary aspergillosis in a patient with chronic granulomatous disease and invasive fungal infection in a profoundly neutropenic patient with acute myelogenous leukemia. During the discussion, diagnostic problems with both culture-based and non-culture-based methods (beta-D-glucan assay, galactomannan assay for Aspergillus, PCR in blood or bronchoalveolar lavage) will be discussed and potential future solutions will be mentioned. Furthermore, challenges of management of specific "œfungal" scenaria will be analyzed and various therapeutic strategies (i.e. prophylactic, empiric and target-specific) will be discussed together with the advantages and disadvantages of each of these strategies. A number of antifungal agents have been developed for IFI in adult patients. In addition to conventional amphotericin B, lipid formulations of amphotericin B, newer azoles and echinocandins have been developed and started to use. Some of them have been studied in pediatric patients as well. Newer antifungal azoles (i.e. voriconazole and posaconazole) as well as echinocandins (i.e. caspofungin, micafungin and anidulafungin) are potential causes of improved outcome of IFI in pediatric patients. Pharmacokinetic and efficacy studies are, however, necessary for the pediatric patients.
2007

abstract No: 

M14

Full conference title: 

3rd Trends in Medical Mycology
    • TIMM 3rd (2011)