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Chapter 40 : Aspergillosis in Pediatric Patients

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Abstract:

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
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