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Pediatric Invasive Aspergillosis: A Retrospective Review of 59 Cases.
Japanese Journal of Infectious Diseases 2022 November 31
Invasive aspergillosis (IA) is an important cause of morbidity and mortality. In this study, we aimed to present our 10-year IA experience in a single center. Fifty-nine pediatric patients diagnosed with IA were included in the study. The male/female ratio of these patients was 42/17. The median age was 8.75 years. Hematologic malignancy was present in the majority of the patients (40/59, 68%). The mean duration of neutropenia was 18.5 days. Cytosine arabinoside was the most common immunosuppressive therapy directed at T-cells at the time of IA diagnosis. IA cases were categorized as proven (27%), probable (51%) and possible (22%) according to the 2008 EORTC/MSG criteria. The most common site of invasive aspergillosis was the lungs (78%) and nodules were the most frequent radiological finding (75.5%). In 38 (64.4%) patients receiving antifungal prophylaxis, prophylactic agents included fluconazole (30.5%), liposomal amphotericin B (23.7%), posaconazole (8.5%) and voriconazole (1.7%) Initial treatment was most commonly administered as monotherapy (69.5%). The median duration of antifungal treatment was 67 days. A total of 11 (18.6%) deaths occurred due to aspergillosis. We will probably continue to see IA frequently in pediatric patients with increased use of corticosteroids, biological agents, and intensive immunosuppressive chemotherapies.
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