Retrospective analysis of 93 cases of invasive fungal infection in children′s lung

Abstract

Objective To explore the clinical manifestations, treatment and prognosis of pulmonaryinvasive fungal infection in children. Methods The clinical, imaging, laboratory examination, treatment and prognosis of 93 children with pulmonary invasive fungal infection that were to be diagnosed or confirmed in the Department of Pediatrics, the First Affiliated Hospital of Guangzhou Medical University, from January 2012 to August 2018 were analyzed retrospectively. Results Among the 93 fungal patients, 64 were male and 29 were female, with an age of (55.18±5.38) months, ranging from one month to 15 years, and a median age of 32 months.The average length of stay was 25.4 days, and the median length of stay was 23 days.The clinical manifestations of all patients were nonspecific, including fever, cough, expectoration, shortness of breath and dyspnea.The pulmonary imaging features were diverse, mainly including slightly thickened / increased lung texture, spot or patchy fuzzy shadow between the textures, accompanied by pulmonary consolidation, diffuse nodular change, etc.Bronchiectasis and mediastinal lymph node were rare.Among the 93 patients, 41 cases (44.1%) were positive for fungal culture in blood / deep sputum, and 22 cases (53.6%) were positive for Candida, two kinds of fungi were cultured in some patients at the same time.72 cases(77.4%) were effective in antifungal therapy, eight cases (8.6%) were abandoned because of basic diseases, six cases (6.5%) were transferred to other hospital, senven cases (7.5%) died.Among them, 41 cases (44.1%) were treated with voriconazole alone or in combination, 38 cases (92.7%) were effective, and three cases (7.3%) died. Conclusions Children with pulmonary invasive fungal infection are more likely to occur in children with serious underlying diseases.Their clinical and imaging manifestations are nonspecific.The mortality and prognosis are closely related to host factors, environmental factors and antifungal treatment.The use of voriconazole antifungal treatment can effectively reduce the mortality of children with pulmonary fungal infection. Key words: Lung diseases, fungal; Pneumonia; Child; Clinical analysis; Treatment