Chapter 40 : Aspergillosis in Pediatric Patients

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in

Aspergillosis in Pediatric Patients, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815523/9781555814380_Chap40-1.gif /docserver/preview/fulltext/10.1128/9781555815523/9781555814380_Chap40-2.gif


Invasive aspergillosis (IA) is one of the most challenging diseases and the cause of significant morbidity and mortality, with an associated cost of more than 25 million U.S. dollars during 2000 in the United States. A recent study from Taiwan reviewed all episodes of invasive fungal infections occurring in children with cancer in one hospital from 1987 to 2005. The study showed that 29 episodes of invasive fungal infections occurred in 26 cancer patients. Diagnosis is largely based on radiological findings, since many diagnostic tools have limited sensitivity and specificity in pediatric patients. Differences in diagnosis of aspergillosis between hematological malignancies and primary immunodeficiencies are discussed this chapter. While the most common species recovered in chronic granulomatous disease (CGD) patients is , there is an increased incidence of reported in CGD patients. In a review of 44 IA cases that occurred in the first 3 months of life, 25% of the patients had cutaneous aspergillosis, 22.7% had IPA, and 31.8% had disseminated disease. The study confirmed prematurity as the main risk factor for this group. An issue related with galactomannan (GM) testing is the increased rate of false-negative results in specific pediatric patients, such as those with CGD. Several studies have been performed to evaluate the efficacy of PCR in comparison to other diagnostic tools such as GM, and they have included pediatric patients as well.

Citation: Roilides E, Panagopoulou P. 2009. Aspergillosis in Pediatric Patients, p 531-546. In Latgé J, Steinbach W (ed), and Aspergillosis. ASM Press, Washington, DC. doi: 10.1128/9781555815523.ch40
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Abbasi, S.,, J. L. Shenep,, W. T. Hughes, and, P. M. Flynn. 1999. aspergillosis in children with cancer: a 34-year experience. Clin. Infect. Dis. 29:12101219.
2. Alioglu, B.,, Z. Avci,, O. Canan,, F. Ozcay,, B. Demirhan, and, N. Oz-bek. 2007. Invasive esophageal aspergillosis associated with acute myelogenous leukemia: successful therapy with combination caspofungin and liposomal amphotericin B. Pediatr. Hematol. Oncol. 24: 6368.
3. Allan, B. T.,, D. Patton,, N. K. Ramsey, and, D. L. Day. 1988. Pulmonary fungal infections after bone marrow transplantation. Pediatr. Radiol. 18: 118122.
4. Almyroudis, N. G.,, S. M. Holland, and, B. H. Segal. 2005. Invasive aspergillosis in primary immunodeficiencies. Med. Mycol. 43:(Suppl. 1):S247S259.
5. Antachopoulos, C,, T. J. Walsh, and, E. Roilides. 2007. Fungal infections in primary immunodeficiencies. Eur. J. Pediatr. 166: 10991117.
6. Assari, T. 2006. Chronic granulomatous disease; fundamental stages in our understanding of CGD. Med. Immunol. 5:4.
7. Baker, C. 2006. Serial Aspergillus antigen monitoring in pediatric bone marrow transplant patients. J. Pediatr. Oncol. Nurs. 23: 300304.
8. Benjamin, D. K., Jr.,, W. C. Miller,, S. Bayliff,, L. Martel,, K. A. Alexander, and, P. L. Martin. 2002. Infections diagnosed in the first year after pediatric stem cell transplantation. Pediatr. Infect. Dis.J. 21: 227234.
9. Benjamin, D. K., Jr.,, T. Driscoll,, N. L. Seibel,, C. E. Gonzalez,, M. M. Roden,, R. Kilaru,, K. Clark,, J. A. Dowell,, J. Schranz, and, T. J. Walsh. 2006. Safety and pharmacokinetics of intravenous anidula-fungin in children with neutropenia at high risk for invasive fungal infections. Antimicrob. Agents Chemother. 50: 632638.
10. Bernhisel-Broadbent, J.,, E. E. Camargo,, H. S. Jaffe, and, H. M. Led-erman. 1991. Recombinant human interferon-7 as adjunct therapy for Aspergillus infection in a patient with chronic granulomatous disease. J. Infect. Dis. 163: 908911.
11. Blyth, C. C,, P. Palasanthiran, and, T. A. O’Brien. 2007. Antifungal therapy in children with invasive fungal infections: a systematic review. Pediatrics 119: 772784.
12. Boes, B.,, R. Bashir,, C. Boes,, F. Hahn,, J. R. McConnell, and, R. Mc-Comb. 1994. Central nervous system aspergillosis. Analysis of 26 patients. J. Neuroimag. 4: 123129.
13. Castagnola, E.,, B. Cappelli,, M. Faraci,, S. Fallani,, M. I. Cassetta, and, A. Novelli. 2007. Maintenance of therapeutic concentrations of caspofungin after temporary treatment interruption (48 hours) in a child with invasive aspergillosis. Antimicrob. Agents Chemother. 51: 3775.
14. Cesaro, S.,, L. Strugo,, R. Alaggio,, G. Cecchetto,, L. Rigobello,, M. Pil-lon,, R. Cusinato, and, L. Zanesco. 2003. Voriconazole for invasive aspergillosis in oncohematological patients: a single-center pediatric experience. Support. Care Cancer 11: 722727.
15. Cesaro, S.,, M. Giacchino,, F. Locatelli,, M. Spiller,, B. Buldini,, C. Cas-tellini,, D. Caselli,, E. Giraldi,, F. Tucci,, G. Tridello,, M. R. Rossi, and, E. Castagnola. 2007. Safety and efficacy of a caspofungin-based combination therapy for treatment of proven or probable aspergillosis in pediatric hematological patients. BMC Infect. Dis. 7:28.
16. Challier, S.,, S. Boyer,, E. Abachin, and, P. Berche. 2004. Development of a serum-based Taqman real-time PCR assay for diagnosis of invasive aspergillosis. J. Clin. Microbiol. 42: 844846.
17. Chatziagorou, E.,, J. N. Tsanakas,, T. J. Walsh, and, E. Roilides. Aspergillus and the pediatric lung. Pediatr. Respir. Rev., in press.
18. Comely, O. A.,, J. Maertens,, M. Bresnik,, R. Ebrahimi,, A. J. Ullmann,, E. Bouza,, C. P. Heussel,, O. Lortholary,, C. Rieger,, A. Boehme,, M. Aoun,, H. A. Horst,, A. Thiebaut,, M. Ruhnke,, D. Reichert,, N. Vi-anelli,, S. W. Krause,, E. Olavarria, and, R. Herbrecht. 2007. Liposomal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad Trial). Clin. Infect. Dis. 44: 12891297.
19. de Almeida, M. B.,, M. H. Bussamra, and, J. C. Rodrigues. 2006. Allergic bronchopulmonary aspergillosis in paediatric cystic fibrosis patients. Paediatr. Respir. Rev. 7: 6772.
20. de Carpentier, J. P.,, L. Ramamurthy,, D. W. Denning, and, P. H. Taylor. 1994. An algorithmic approach to Aspergillus sinusitis. J. Lar-yngol. Otol. 108:314318.
21. Denning, D. W. 1998. Invasive aspergillosis. Clin. Infect. Dis. 26: 781803.
22. Donoso, F. A.,, A. J. Camacho,, L. P. Alarcon, and, R. P. Cruces. 2006. Invasive multisystemic aspergillosis in an immunocompetent child: case report. Rev. Chilena Infectol. 23:6972. (In Spanish.)
23. Dotis, J.,, P. Panagopoulou,, J. Filioti,, R. Winn,, C. Toptsis,, C. Pante-liadis, and, E. Roilides. 2003. Femoral osteomyelitis due to Aspergillus nidulans in a patient with chronic granulomatous disease. Infection 31:121124.
24. Dotis, J., and, E. Roilides. 2004. Osteomyelitis due to Aspergillus spp. in patients with chronic granulomatous disease: comparison of As-pergillus nidulans and Aspergillus fumigatus. Int. J. Infect. Dis. 8: 103110.
25. Dotis, J.,, E. Iosifidis, and, E. Roilides. 2007. Central nervous system aspergillosis in children: a systematic review of reported cases. Int. J. Infect. Dis. 11:381393.
26. Drut, R.,, V. Anderson,, M. A. Greco,, C. Gutierrez,, B. de Leon-Bojorge,, D. Menezes,, A. Peruga,, G. Quijano,, C. Ridaura,, M. Siminovich,, P. V. Mayoral,, M. Weissenbacher, et al. 1997. Opportunistic infections in pediatric HIV infection: a study of 74 autopsy cases from Latin America. Pediatr. Pathol. Lab. Med. 17:569576.
27. Foy, P. C.,, J. A. van Burik, and, D. J. Weisdorf. 2007. Galactomannan antigen enzyme-linked immunosorbent assay for diagnosis of invasive aspergillosis after hematopoietic stem cell transplantation. Biol. Blood Marrow Transplant. 13:440443.
28. Francesconi, A.,, M. Kasai,, R. Petraitiene,, V. Petraitis,, A. M. Kelaher,, R. Schaufele,, W. W. Hope,, Y. R. Shea,, J. Bacher, and, T. J. Walsh. 2006. Characterization and comparison of galactomannan enzyme immunoassay and quantitative real-time PCR assay for detection of Aspergillus fumigatus in bronchoalveolar lavage fluid from experimental invasive pulmonary aspergillosis. J. Clin. Microbiol. 44: 24752480.
29. Frankenbusch, K.,, F. Eifinger,, A. Kribs,, J. Rengelshauseu, and, B. Roth. 2006. Severe primary cutaneous aspergillosis refractory to amphotericin B and the successful treatment with systemic voricon-azole in two premature infants with extremely low birth weight. J. Perinatol. 26:511514.
30. Freeman, A. F.,, D. E. Kleiner,, H. Nadiminti,, J. Davis,, M. Quezado,, V. Anderson,, J. M. Puck, and, S. M. Holland. 2007. Causes of death in hyper-IgE syndrome. J. Allergy Clin. Immunol. 119:12341240.
31. Fuchs, H.,, H. von Baum,, M. Meth,, N. Wellinghausen,, W. Lindner, and, H. Hummler. 2006. CNS manifestation of aspergillosis in an extremely low-birth-weight infant. Eur. J. Pediatr. 165:476480.
32. Gallin, J. I.,, D. W. Alling,, H. L. Malech,, R. Wesley,, D. Koziol,, B. Marciano,, E. M. Eisenstein,, M. L. Turner,, E. S. DeCarlo,, J. M. Starling, and, S. M. Holland. 2003. Itraconazole to prevent fungal infections in chronic granulomatous disease. N. Engl. J. Med. 348: 24162422.
33. Gefter, W. B.,, S. M. Albelda,, G. H. Talbot,, S. L. Gerson,, P. A. Cassileth, and, W. T. Miller. 1985. Invasive pulmonary aspergillosis and acute leukemia. Limitations in the diagnostic utility of the air crescent sign. Radiology 157:605610.
34. Gerson, S. L.,, G. H. Talbot,, S. Hurwitz,, B. L. Strom,, E. J. Lusk, and, P. A. Cassileth. 1984. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann. Intern. Med. 100:345351.
35. Greenberger, P. A. 2002. Allergic bronchopulmonary aspergillosis. J. Allergy Clin. Immunol. 110:685692.
36. Groll, A. H.,, G. Jaeger,, A. Allendorf,, G. Herrmann,, R. Schloesser, and, V. von Loewenich. 1998a. Invasive pulmonary aspergillosis in a critically ill neonate: case report and review of invasive aspergillosis during the first 3 months of life. Clin. Infect. Dis. 27:437452.
37. Groll, A. H.,, F. M. Muller,, S. C. Piscitelli, and, T. J. Walsh. 1998b. Lipid formulations of amphotericin B: clinical perspectives for the management of invasive fungal infections in children with cancer. Klin. Paediatr. 210: 264273.
38. Groll, A. H., and, T. J. Walsh. 2001. Uncommon opportunistic fungi: new nosocomial threats. Clin. Microbiol. Infect. 7:(Suppl. 2):824.
39. Groll, A. H.,, A. Attarbaschi,, F. R. Schuster,, N. Herzog,, L. Grigull,, M. N. Dworzak,, K. Beutel,, H. J. Laws, and, T. Lehrnbecher. 2006. Treatment with caspofungin in immunocompromised paediatric patients: a multicentre survey. J. Antimicrob. Chemother. 57: 527535.
40. Gulen, H.,, A. Erbay,, F. Gulen,, E. Kazanci,, C. Vergin,, E. Demir, and, R. Tanac. 2006. Sinopulmonary aspergillosis in children with hematological malignancy. Minerva Pediatr. 58: 319324.
41. Hasan, R. A., and, W. Abuhammour. 2006. Invasive aspergillosis in children with hematologic malignancies. Paediatr. Drugs 8: 1524.
42. Herbrecht, R.,, A. Auvrignon,, E. Andres,, R. Guillemain,, A. Sue,, D. Eyer,, C. Pailler,, V. Letscher-Bru,, G. Leverger, and, G. Schaison. 2001. Efficacy of amphotericin B lipid complex in the treatment of invasive fungal infections in immunosuppressed paediatric patients. Eur. J. Clin. Microbiol. Infect. Dis. 20: 7782.
43. Herbrecht, R.,, D. W. Denning,, T. F. Patterson,, J. E. Bennett,, R. E. Greene,, J. W. Oestmann,, W. V. Kern,, K. A. Marr,, P. Ribaud,, O. Lortholary,, R. Sylvester,, R. H. Rubin,, J. R. Wingard,, P. Stark,, C. Durand,, D. Caillot,, E. Thiel,, P. H. Chandrasekar,, M. R. Hodges,, H. T. Schlamm,, P. F. Troke, and, B. de Pauw. 2002a. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N. Engl. J. Med. 347: 408415.
44. Herbrecht, R.,, V. Letscher-Bru,, C. Oprea,, B. Lioure,, J. Waller,, F. Campos,, O. Villard,, K. L. Liu,, S. Natarajan-Ame,, P. Lutz,, P. Dufour,, J. P. Bergerat, and, E. Candolfi. 2002b. Aspergillus galactomannan detection in the diagnosis of invasive aspergillosis in cancer patients. J. Clin. Oncol. 20: 18981906.
45. Herbrecht, R. 2004. Posaconazole: a potent, extended-spectrum tria- zole anti-fungal for the treatment of serious fungal infections. Int. J. Clin. Pract. 58: 612624.
46. Herron, M. D.,, S. L. Vanderhooft,, C. Byington, and, J. D. King. 2003. Aspergillosis in a 24-week newborn: a case report. J. Perinatol. 23: 256259.
47. Hope, W. W.,, T. J. Walsh, and, D. W. Denning. 2005. The invasive and saprophytic syndromes due to Aspergillus spp. Med. Mycol. 43:(Suppl. 1):S207S238.
48. Horvath, J. A., and, S. Dummer. 1996. The use of respiratory-tract cultures in the diagnosis of invasive pulmonary aspergillosis. Am. J. Med. 100: 171178.
49. Hovi, L.,, U. M. Saarinen-Pihkala,, K. Vettenranta, and, H. Saxen. 2000. Invasive fungal infections in pediatric bone marrow transplant recipients: single center experience of 10 years. Bone Marrow Transplant. 26: 9991004.
50. Johnston, R. B., Jr., and, R. L. Baehner. 1971. Chronic granulomatous disease: correlation between pathogenesis and clinical findings. Pediatrics 48: 730739.
51. Kawazu, M.,, Y. Kanda,, Y. Nannya,, K. Aoki,, M. Kurokawa,, S. Chiba,, T. Motokura,, H. Hirai, and, S. Ogawa. 2004. Prospective comparison of the diagnostic potential of real-time PCR, double-sandwich enzyme-linked immunosorbent assay for galactomannan, and a (1—>3)-/3-D-glucan test in weekly screening for invasive aspergillosis in patients with hematological disorders. J. Clin. Microbiol. 42: 27332741.
52. Khoo, S. H., and, D. W. Denning. 1994. Invasive aspergillosis in patients with AIDS. Clin. Infect. Dis. 19:(Suppl. 1):S41S48.
53. Kohli, U.,, J. Sahu,, R. Lodha,, N. Agarwal, and, R. Ray. 2007. Invasive nosocomial aspergillosis associated with heart failure and complete heart block following recovery from dengue shock syndrome. Pediatr. Crit. Care Med. 8: 389391.
54. Krishna, G.,, A. Sansone-Parsons,, M. Martinho,, B. Kantesaria, and, L. Pedicone. 2007. Posaconazole plasma concentrations in juvenile pa- tients with invasive fungal infection. Antimicrob. Agents Chemother. 51:812818.
55. Krivan, G.,, J. Sinko,, I. Z. Nagy,, V. Goda,, P. Remenyi,, A. Batai,, S. Lueff,, B. Kapas,, M. Reti,, A. Tremmel, and, T. Masszi. 2006. Successful combined antifungal salvage therapy with liposomal amphothericin B and caspofungin for invasive Aspergillus flavus infection in a child following allogeneic bone marrow transplantation. Acta Biomed. 77:(Suppl. 2):1721.
56. Kume, H.,, T. Yamazaki,, M. Abe,, H. Tanuma,, M. Okudaira, and, I. Okayasu. 2003. Increase in aspergillosis and severe mycotic infection in patients with leukemia and MDS: comparison of the data from the Annual of the Pathological Autopsy Cases in Japan in 1989, 1993 and 1997. Pathol. Int. 53:744750.
57. Lehrnbecher, T.,, M. Becker,, D. Schwabe,, U. Kohl,, S. Kriener,, K. P. Hunfeld,, H. Schmidt,, P. Beyer,, T. Klingebiel,, P. Bader, and, J. Sor-ensen. 2006. Primary intestinal aspergillosis after high-dose chemotherapy and autologous stem cell rescue. Pediatr. Infect. Dis. J. 25:465466.
58. Leroy, P.,, A. Smismans, and, T. Seute. 2006. Invasive pulmonary and central nervous system aspergillosis after near-drowning of a child: case report and review of the literature. Pediatrics 118:e509e513.
59. Liese, J.,, S. Kloos,, V. Jendrossek,, T. Petropoulou,, U. Wintergerst,, G. Notheis,, M. Gahr, and, B. H. Belohradsky. 2000. Long-term follow-up and outcome of 39 patients with chronic granulomatous disease. J. Pediatr. 137:687693.
60. Lin, S. J.,, J. Schranz, and, S. M. Teutsch. 2001. Aspergillosis case-fatality rate: systematic review of the literature. Clin. Infect. Dis. 32:358366.
61. Mamishi, S.,, K. Zomorodian,, F. Saadat,, M. Gerami-Shoar,, B. Tara-zooie, and, S. A. Siadati. 2005. A case of invasive aspergillosis in CGD patient successfully treated with amphotericin B and IFN-gamma. Ann. Clin. Microbiol. Antimicrob. 4:4.
62. Marr, K. A., and, R. A. Bowden. 1999. Fungal infections in patients undergoing blood and marrow transplantation. Transplant. Infect. Dis. 1:237246.
63. Marr, K. A.,, R. A. Carter,, F. Crippa,, A. Wald, and, L. Corey. 2002. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin. Infect. Dis. 34:909917.
64. Mastella, G.,, M. Rainisio,, H. K. Harms,, M. E. Hodson,, C. Koch,, J. Navarro,, B. Strandvik,, S. G. McKenzie, et al. 2000. Allergic bronchopulmonary aspergillosis in cystic fibrosis. A European epidemiological study. Eur. Respir. J. 16:464471.
65. McNeil, M. M.,, S. L. Nash,, R. A. Hajjeh,, M. A. Phelan,, L. A. Conn,, B. D. Plikaytis, and, D. W. Warnock. 2001. Trends in mortality due to invasive mycotic diseases in the United States, 1980–1997. Clin. Infect. Dis. 33:641647.
66. Mennink-Kersten, M. A. S. H.,, R. R. Klont,, A. Warris,, H. J. M. Op den Camp, and, P. E. Verweij. 2004. Bifidobacterium lipoteichoic acid and false ELISA reactivity in Aspergillus antigen detection. Lancet 363:325327.
67. Moskaluk, C. A.,, H. W. Pogrebniak,, H. I. Pass,, J. I. Gallin, and, W. D. Travis. 1994. Surgical pathology of the lung in chronic granulomatous disease. Am. J. Clin. Pathol. 102:684691.
68. Mouy, R.,, A. Fischer,, E. Vilmer,, R. Seger, and, C. Griscelli. 1989. Incidence, severity, and prevention of infections in chronic granulomatous disease. J. Pediatr. 114:555560.
69. Muller, F. M.,, A. H. Groll, and, T. J. Walsh. 1999. Current approaches to diagnosis and treatment of fungal infections in children infected with human immunodeficiency virus. Eur. J. Pediatr. 158: 187199.
70. Ostrosky-Zeichner, L.,, K. A. Marr,, J. H. Rex, and, S. H. Cohen. 2003. Amphotericin B: time for a new “gold standard”. Clin. Infect. Dis. 37:415425.
71. Perfect, J. R.,, G. M. Cox,, J. Y. Lee,, C. A. Kauffman,, L. de Repentigny,, S. W. Chapman,, V. A. Morrison,, P. Pappas,, J. W. Hiemenz, and, D. A. Stevens. 2001. The impact of culture isolation of Aspergillus species: a hospital-based survey of aspergillosis. Clin. Infect. Dis. 33:18241833.
72. Petraitis, V.,, R. Petraitiene,, A. A. Sarafandi,, A. M. Kelaher,, C. A. Lyman,, H. E. Casler,, T. Sein,, A. H. Groll,, J. Bacher,, N. A. Avila, and, T. J. Walsh. 2003. Combination therapy in treatment of experimental pulmonary aspergillosis: synergistic interaction between an antifungal triazole and an echinocandin. J. Infect. Dis. 187: 18341843.
73. Reik, R. A.,, M. M. Rodriguez, and, G. T. Hensley. 1995. Infections in children with human immunodeficiency virus/acquired immunodeficiency syndrome: an autopsy study of 30 cases in south Florida, 1990–1993. Pediatr. Pathol. Lab. Med. 15:269281.
74. Roilides, E.,, E. Pavlidou,, F. Papadopoulos,, C. Panteliadis,, E. Farmaki,, M. Tamiolaki, and, J. Sotiriou. 2003. Cerebral aspergillosis in an infant with corticosteroid-resistant nephrotic syndrome. Pediatr. Nephrol. 18:450453.
75. Roilides, E. 2006. Early diagnosis of invasive aspergillosis in infants and children. Med. Mycol. 44:S199S205.
76. Sallmann, S.,, A. Heilmann,, F. Heinke,, M. L. Kerkmann,, M. Schup-pler,, G. Hahn,, M. Gahr,, A. Rosen-Wolff, and, J. Roesler. 2003. Capofungin therapy for Aspergillus lung infection in a boy with chronic granulomatous disease. Pediatr. Infect. Dis. J. 22:199200.
77. Saulsbury, F. T. 2001. Successful treatment of Aspergillus brain abscess with itraconazole and interferon-gamma in a patient with chronic granulomatous disease. Clin. Infect. Dis. 32:E137E139.
78. Schuster, F.,, C. Moelter,, I. Schmid,, U. B. Graubner,, B. Kammer,, B. H. Belohradsky, and, M. Fuhrer. 2005. Successful antifungal combination therapy with voriconazole and caspofungin. Pediatr. Blood Cancer 44:682685.
79. Schwartz, S.,, M. Ruhnke,, P. Ribaud,, L. Corey,, T. Driscoll,, O. A. Cornely,, U. Schuler,, I. Lutsar,, P. Troke, and, E. Thiel. 2005. Improved outcome in central nervous system aspergillosis, using vor-iconazole treatment. Blood 106:26412645.
80. Scott, L. J., and, D. Simpson. 2007. Voriconazole: a review of its use in the management of invasive fungal infections. Drugs 67:269298.
81. Segal, B. H.,, E. S. DeCarlo,, K. J. Kwon-Chung,, H. L. Malech,, J. I. Gallin, and, S. M. Holland. 1998. Aspergillus nidulans infection in chronic granulomatous disease. Medicine (Baltimore) 77:345354.
82. Shetty, D.,, N. Giri,, C. E. Gonzalez,, P. A. Pizzo, and, T. J. Walsh. 1997. Invasive aspergillosis in human immunodeficiency virus-infected children. Pediatr. Infect. Dis. J. 16:216221.
83. Shouldice, E.,, C. Fernandez,, B. McCully,, M. Schmidt,, R. Fraser, and, C. Cook. 2003. Voriconazole treatment of presumptive disseminated Aspergillus infection in a child with acute leukemia. J. Pediatr. Hematol. Oncol. 25:732734.
84. Simon, A.,, M. Besuden,, S. Vezmar,, C. Hasan,, D. Lampe,, S. Kreutz-berg,, A. Glasmacher,, U. Bode, and, G. Fleischhack. 2007. Itracon-azole prophylaxis in pediatric cancer patients receiving conventional chemotherapy or autologous stem cell transplants. Support. Care Cancer 15:213220.
85. Steinbach, W. J. 2005. Pediatric aspergillosis: disease and treatment differences in children. Pediatr. Infect. Dis. J. 24:358364.
86. Steinbach, W. J.,, R. M. Addison,, L. McLaughlin,, Q. Gerrald,, P. L. Martin,, T. Driscoll,, C. Bentsen,, J. R. Perfect, and, B. D. Alexander. 2007. Prospective Aspergillus galactomannan antigen testing in pediatric hematopoietic stem cell transplant recipients. Pediatr. Infect. Dis. J. 26:558564.
87. Sterba, J.,, J. Prochazka,, J. Ventruba,, L. Kren,, D. Valik,, D. Burgetova,, P. Mudry,, J. Skotakova, and, J. Blatny. 2005. Successful treatment of Aspergillus brain abscess in a child with acute lymphoblastic leukemia and liver failure. Pediatr. Hematol. Oncol. 22:649655.
88. Stergiopoulou, T.,, J. Meletiadis,, E. Roilides,, D. E. Kleiner,, R. Schau-fele,, M. Roden,, S. Harrington,, L. Dad,, B. Segal, and, T. J. Walsh. 2007. Host-dependent patterns of tissue injury in invasive pulmonary aspergillosis. Am. J. Clin. Pathol. 127:349355.
89. Stevens, D. A.,, R. B. Moss,, V. P. Kurup,, A. P. Knutsen,, P. Greenber-ger,, M. A. Judson,, D. W. Denning,, R. Crameri,, A. S. Brody,, M. Light,, M. Skov,, W. Maish, and, G. Mastella. 2003. Allergic bronchopulmonary aspergillosis in cystic fibrosis: state of the art. Cystic Fibrosis Foundation Consensus Conference. Clin. Infect. Dis. 37:(Suppl. 3):S225S264.
90. Stiefel, M.,, T. Reiss,, M. S. Staege,, J. Rengelshausen,, J. Burhenne,, A. Wawer, and, J. L. Foell. 2007. Successful treatment with voricona-zole of Aspergillus brain abscess in a boy with medulloblastoma. Pediatr. Blood Cancer 49:203207.
91. Sulahian, A.,, M. Tabouret,, P. Ribaud,, J. Sarfati,, E. Gluckman,, J. P. Latgé, and, F. Derouin. 1996. Comparison of an enzyme immunoassay and latex agglutination test for detection of galactomannan in the diagnosis of invasive aspergillosis. Eur. J. Clin. Microbiol. Infect. Dis. 15:139145.
92. Taccone, A.,, M. Occhi,, A. Garaventa,, L. Manfredini, and, C. Viscoli. 1993. CT of invasive pulmonary aspergillosis in children with cancer. Pediatr. Radiol. 23: 177180.
93. Thomas, K. E.,, C. M. Owens,, P. A. Veys,, V. Novelli, and, V. Costoli. 2003. The radiological spectrum of invasive aspergillosis in children: a 10-year review. Pediatr. Radiol. 33:453460.
94. Tillie-Leblond, I., and, A. B. Tonnel. 2005. Allergic bronchopulmonary aspergillosis. Allergy 60:10041013.
95. van’t Hek, L. G.,, P. E. Verweij,, C. M. Weemaes,, R. van Dalen,, J. B. Yntema, and, J. F. Meis. 1998. Successful treatment with voricon-azole of invasive aspergillosis in chronic granulomatous disease. Am. J. Respir. Crit. Care Med. 157:16941696.
96. Verdaguer, V.,, T. J. Walsh,, W. Hope, and, K. J. Cortez. 2007. Ga-lactomannan antigen detection in the diagnosis of invasive aspergillosis. Expert Rev. Mol. Diagn. 7:2132.
97. Verweij, P. E.,, C. M. Weemaes,, J. H. Curfs,, S. Bretagne, and, J. F. Meis. 2000. Failure to detect circulating Aspergillus markers in a patient with chronic granulomatous disease and invasive aspergillosis. J. Clin. Microbiol. 38:39003901.
98. Verweij, P. E.,, E. Mellado, and, W. J. Melchers. 2007. Multiple-triazole-resistant aspergillosis. N. Engl. J. Med. 356:14811483.
99. Walmsley, S.,, S. Devi,, S. King,, R. Schneider,, S. Richardson, and, L. Ford-Jones. 1993. Invasive Aspergillus infections in a pediatric hospital: a ten-year review. Pediatr. Infect. Dis. J. 12:673682.
100. Walsh, T. J. 1998. Primary cutaneous aspergillosis: an emerging infection among immunocompromised patients. Clin. Infect. Dis. 27: 453457.
101. Walsh, T. J.,, N. L. Seibel,, C. Arndt,, R. E. Harris,, M. J. Dinubile, and, A. Reboli. 1999. Amphotericin B lipid complex in pediatric patients with invasive fungal infections. Pediatr. Infect. Dis. 18:702708.
102. Walsh, T. J.,, I. Lutsar,, T. Driscoll,, B. Dupont,, M. Roden,, P. Ghah-ramani,, M. Hodges,, A. H. Groll, and, J. R. Perfect. 2002a. Vori-conazole in the treatment of aspergillosis, scedosporiosis and other invasive fungal infections in children. Pediatr. Infect. Dis. J. 21: 240248.
103. Walsh, T. J.,, M. O. Karlsson,, T. Driscoll,, A. G. Arguedas,, P. Ad-amson,, X. Saez-Llorens,, A. J. Vora,, A. C. Arrieta,, J. Blumer,, I. Lutsar,, P. Milligan, and, N. Wood. 2004. Pharmacokinetics and safety of intravenous voriconazole in children after single- or multiple-dose administration. Antimicrob. Agents Chemother. 48: 21662172.
104. Walsh, T. J.,, P. C. Adamson,, N. L. Seibel,, P. M. Flynn,, M. N. Neely,, C. Schwartz,, A. Shad,, S. L. Kaplan,, M. M. Roden,, J. A. Stone,, A. Miller,, S. K. Bradshaw,, S. X. Li,, C. A. Sable, and, N. A. Kartsonis. 2005. Pharmacokinetics, safety, and tolerability of caspofungin in children and adolescents. Antimicrob. Agents Chemother. 49: 45364545.
105. Warris, A.,, P. E. Verweij,, R. Barton,, D. C. Crabbe,, E. G. Evans, and, J. F. Meis. 1999. Invasive aspergillosis in two patients with Pearson syndrome. Pediatr. Infect. Dis. J. 18:739741.
106. Wilhelm, L.,, M. S. McLeary, and, D. Janner. 2000. MR diagnosis of pulmonary and chest wall aspergillosis as an initial presentation of chronic granulomatous disease in a 7-month-old male. Pediatr. Ra-diol. 30:719720.
107. Winkelstein, J. A.,, M. C. Marino,, R. B. Johnston, Jr.,, J. Boyle,, J. Curnutte,, J. I. Gallin,, H. L. Malech,, S. M. Holland,, H. Ochs,, P. Quie,, R. H. Buckley,, C. B. Foster,, S. J. Chanock, and, H. Dickler. 2000. Chronic granulomatous disease. Report on a national registry of 368 patients. Medicine (Baltimore) 79:155169.
108. Winkelstein, J. A.,, M. C. Marino,, H. Ochs,, R. Fuleihan,, P. R. Scholl,, R. Geha,, E. R. Stiehm, and, M. E. Conley. 2003. The X-linked hyper-IgM syndrome: clinical and immunologic features of 79 patients. Medicine (Baltimore) 82:373384.
109. Yeh, T. C.,, H. C. Liu,, L. Y. Wang,, S. H. Chen, and, D. C. Liang. 2007. Invasive fungal infection in children undergoing chemotherapy for cancer. Ann. Trop. Paediatr. 27: 141147.
110. Zaoutis, T. E.,, K. Heydon,, J. H. Chu,, T. J. Walsh, and, W. J. Stein-bach. 2006. Epidemiology, outcomes, and costs of invasive aspergillosis in immunocompromised children in the United States, 2000. Pediatrics 117:e711e716.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error