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Clinical features in proven and probable invasive fungal disease in children and adolescents at a pediatric referral center: a 5-year experience

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Abstract

Background

There is limited information concerning the overall epidemiology of invasive fungal disease (IFD) in children. The aim of this study was to clarify the clinical features of IFD in a tertiary pediatric care hospital.

Methods

Patients diagnosed with proven or probable IFD at our hospital between 2011 and 2015 were retrospectively reviewed. Proven and probable IFD were defined according to the European Organization for Research and Treatment of Cancer/Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group consensus. Patients with possible IFD were excluded.

Results

The incidence of proven or probable IFD was 26 of 20,079 hospitalized patients (0.13%). The predominant underlying disease was malignancy (54%) and congenital anomaly (27%). The most common diagnosis was candidemia among the patients with proven IFD (8 of 13, 62%). All the isolated pathogens in the candidemia patients were non-albicans Candida spp. The most common site of infection was the lungs in patients with probable IFD (11 of 13 patients, 85%). In probable IFD episodes, positive β-D-glucan and galactomannan were found in 12 of 13 (92%) and 5 of 13 (38%) patients, respectively. All but one patient (96%) received empirical antifungal therapy. No patients underwent surgical resection of residual lesions. The overall mortality was 23% and the attributable mortality of IFD was 12%.

Conclusion

Our results suggest the emergence of non-albicans Candida species as important pathogens in childhood IFD.

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Acknowledgements

This study was supported by the Academic Award 2016 from the Central Division of the Japanese Association for Infectious Disease.

Funding

The authors received no specific funding for this study.

Author information

Authors and Affiliations

  1. Department of Hematology and Oncology, Children’s Cancer Center, Kobe Children’s Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan

    Kenji Kishimoto, Daiichiro Hasegawa & Yoshiyuki Kosaka

  2. Department of Infectious Disease, Kobe Children’s Hospital, Kobe, Japan

    Masashi Kasai & Yusuke Ito

  3. Department of Clinical Laboratory, Kobe Children’s Hospital, Kobe, Japan

    Noriko Kawamura

  4. Department of Diagnostic Pathology, Kobe Children’s Hospital, Kobe, Japan

    Makiko Yoshida

  5. Department of Pediatrics, Kita-Harima Medical Center, Kobe, Japan

    Keiichiro Kawasaki

Authors
  1. Kenji Kishimoto
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  2. Masashi Kasai
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  3. Noriko Kawamura
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  4. Yusuke Ito
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  5. Makiko Yoshida
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  6. Daiichiro Hasegawa
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  7. Keiichiro Kawasaki
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  8. Yoshiyuki Kosaka
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Contributions

Conceived of or designed study: KK, KM, IY, and KY. Performed research: KK, KN, and YM. Analyzed data: KK, IY, HD, and KK. Wrote the paper: KK and KM.

Corresponding author

Correspondence to Kenji Kishimoto.

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Ethical approval

This study was approved by the Institutional Review Board of Kobe Children’s Hospital. All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee.

Conflict of interest

The authors declare that they have no conflict of interest. No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

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Kishimoto, K., Kasai, M., Kawamura, N. et al. Clinical features in proven and probable invasive fungal disease in children and adolescents at a pediatric referral center: a 5-year experience. World J Pediatr 15, 270–275 (2019). https://doi.org/10.1007/s12519-019-00259-x

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  • DOI: https://doi.org/10.1007/s12519-019-00259-x

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