Fungal Infections in the Pediatric Age Group

Abstract

Cutaneous fungal infections occur in the pediatric age group and are a particular concern when they occur in premature or otherwise immunocompromised children. Clinical manifestations can result from infection with yeasts as well as dermatophytes. The most common fungal infection in healthy infants is Candida diaper dermatitis, which usually occurs as a secondary phenomenon following the development of contact dermatitis from the irritating effects of stool and urine. Candida paronychia from thumb-sucking may also occur in this age group. Older children are more likely to contract dermatophyte infections, sometimes transmitted from pets (e.g., Microsporum canis scalp or skin infections) or from other infected individuals (Trichophyton tonsurans). Adolescents are at higher risk for pityrosporum infections (commonly labeled with the misnomer tinea versicolor) and dermatophyte infections of the groin, feet, and nails. Systemic infection from any of the aforementioned infections does not occur in healthy, immunocompetent infants and children. Premature and immunocompromised individuals however are at risk for invasive infection with common pathogens such as Candida, pityrosporum, and opportunistic fungal pathogens such as Aspergillus. The increased incidence of immunosuppressed children, the use of immunosuppressive agents, and broad-spectrum anti-infective drugs make life-threatening infections from ubiquitous fungi a more common occurrence in children. A high index of suspicion for these disorders in at-risk populations, and early recognition of suspicious lesions is crucial to decrease associated morbidity and mortality. In this chapter, we will present several representative cases of fungal infections with potential for significant consequences in the pediatric population.