Abstract
This paper reviews recent advances in three selected areas of pediatric invasive candidiasis: epidemiology, diagnosis, and treatment. Although the epidemiological trends of pediatric invasive candidiasis illustrate a declining incidence, this infection still carries a heavy burden of mortality and morbidity that warrants a high index of clinical suspicion, the need for rapid diagnostic systems, and the early initiation of antifungal therapy. The development of non-culture-based technologies, such as the T2Candida system and (1→3)-β-d-glucan detection assay, offers the potential for early laboratory detection of candidemia and CNS candidiasis, respectively. Among the complications of disseminated candidiasis in infants and children, hematogenous disseminated Candida meningoencephalitis (HCME) is an important cause of neurological morbidity. Detection of (1→3)-β-d-glucan in cerebrospinal fluid serves as an early diagnostic indicator and an important biomarker of therapeutic response. The recently reported pharmacokinetic data of liposomal amphotericin B in children demonstrate dose–exposure relationships similar to those in adults. The recently completed randomized clinical trial of micafungin versus deoxycholate amphotericin B in the treatment of neonatal candidemia provides further safety data for an echinocandin in this clinical setting.
Highlights
This paper reviews the recent advances in three selected areas of pediatric invasive candidiasis: epidemiology, diagnosis, and treatment, as presented in a lecture at the 20th Meeting of the International Immunocompromised Host Society
The clinical manifestations of invasive candidiasis include endophthalmitis, hematogenous Candida meningoencephalitis (HCME), endocarditis, hepatosplenic candidiasis, acute disseminated candidiasis, renal candidiasis, and osteoarticular infections
The study was terminated early because of low recruitment, fungal-free survival was observed in 12 out of the 20 [60%; 95% CI: 36–81%] infants treated with micafungin, versus 7 of the 10 (70%; 95% CI: 35–93%) infants treated with amphotericin B deoxycholate
Summary
This paper reviews the recent advances in three selected areas of pediatric invasive candidiasis: epidemiology, diagnosis, and treatment, as presented in a lecture at the 20th Meeting of the International Immunocompromised Host Society. The paper reviews the nationwide secular trends of pediatric invasive candidiasis in the United States and Europe. Our review further discusses new approaches to laboratory diagnosis and therapeutic monitoring while underscoring the continued need for bedside clinical evaluation. We further review recent studies in pediatric antifungal. J. Fungi 2019, 5, 11 pharmacology and therapeutics that provide new insights into safety, tolerability, pharmacokinetics, and efficacy for the management of invasive candidiasis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
