Invasive zygomycosis in neonates and children.
Title | Invasive zygomycosis in neonates and children. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Roilides, E., Zaoutis T. E., & Walsh T. J. |
Journal | Clin Microbiol Infect |
Volume | 15 Suppl 5 |
Pagination | 50-4 |
Date Published | 2009 Oct |
ISSN | 1469-0691 |
Keywords | Adolescent, Age Factors, Antifungal Agents, Child, Child, Preschool, Debridement, Humans, Infant, Infant, Newborn, Risk Factors, Zygomycosis |
Abstract | Invasive zygomycosis in neonates and children has both similarities to and differences from that in adults. We searched PubMed and individual references for English-language reports of single cases or case series of neonatal (<1 month) and paediatric (< or =18 years) zygomycosis and compared the results with published results in adults. Cases were included if they fulfilled pre-specified criteria. A total of 59 cases of neonatal zygomycosis were reported to July 2007; 157 paediatric cases were published up to 2004 and an additional 30 paediatric cases were reported more recently. Prematurity was a major underlying factor among neonatal cases. The most common manifestations of zygomycosis were gastrointestinal (54%) and cutaneous (36%). This pattern differs from the sinopulmonary and rhinocerebral patterns typical in older children and adults. Overall mortality was 64% in neonates, 56% in children and 53% in adults. A tendency for dissemination was higher in neonates than adults. Dissemination and young age (<1 year) were independent risk factors for death in children. Most patients who survived received antifungal therapy. Surgery combined with antifungal therapy was a protective factor against death. Most neonates and children who survived had received an amphotericin B formulation. Zygomycosis is a life-threatening infection in children and neonates with differing patterns of involvement in individuals of different ages. The most common management strategy in survivors involved a combination of amphotericin B and surgery. |
DOI | 10.1111/j.1469-0691.2009.02981.x |
Alternate Journal | Clin. Microbiol. Infect. |
PubMed ID | 19754758 |