TY  - JOUR
A1  - Seidel, Danila
A1  - Hassler, Angela
A1  - Salmanton-García, Jon
A1  - Koehler, Philipp
A1  - Mellinghoff, Sibylle C.
A1  - Carlesse, Fabianne
A1  - Cheng, Matthew P.
A1  - Falces-Romero, Iker
A1  - Herbrecht, Raoul
A1  - Jover Sáenz, Alfredo
A1  - Klimko, Nikolai
A1  - Mareş, Mihai
A1  - Lass-Flörl, Cornelia
A1  - Soler-Palacín, Pere
A1  - Wisplinghoff, Hilmar
A1  - Cornely, Oliver Andreas
A1  - Pana, Zoi
A1  - Lehrnbecher, Thomas
T1  - Invasive Scedosporium spp. and Lomentospora prolificans infections in pediatric patients: Analysis of 55 cases from FungiScope® and the literature
T2  - International journal of infectious diseases
N2  - Objectives: Current knowledge on infections caused by Scedosporium spp. and Lomentospora prolificans in children is scarce. We therefore aim to provide an overview of risk groups, clinical manifestation and treatment strategies of these infections.
Methods: Pediatric patients (age ≤18 years) with proven/probable Scedosporium spp. or L. prolificans infection were identified in PubMed and the FungiScope® registry. Data on diagnosis, treatment and outcome were collected.
Results: Fifty-five children (median age 9 years [IQR: 5–14]) with invasive Scedosporium spp. (n = 33) or L. prolificans (n = 22) infection were identified between 1990 and 2019. Malignancy, trauma and near drowning were the most common risk factors. Infections were frequently disseminated. Most patients received systemic antifungal therapy, mainly voriconazole and amphotericin B, plus surgical treatment.
Overall, day 42 mortality was 31%, higher for L. prolificans (50%) compared to Scedosporium spp. (18%). L. prolificans infection was associated with a shorter median survival time compared to Scedosporium spp. (6 days [IQR: 3–28] versus 61 days [IQR: 16–148]). Treatment for malignancy and severe disseminated infection were associated with particularly poor outcome (HR 8.33 [95% CI 1.35–51.40] and HR 6.12 [95% CI 1.52–24.66], respectively). Voriconazole use at any time and surgery for antifungal treatment were associated with improved clinical outcome (HR 0.33 [95% CI 0.11–0.99] and HR 0.09 [95% CI 0.02–0.40], respectively).
Conclusions: Scedosporium spp. and L. prolificans infections in children are associated with high mortality despite comprehensive antifungal therapy. Voriconazole usage and surgical intervention are associated with successful outcome.
KW  - Scedosporium spp.
KW  - Lomentospora prolificans
KW  - Invasive fungal infections
KW  - Pediatric patients
KW  - Children
KW  - Voriconazole
KW  - Surgery
KW  - FungiScope® registry
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/53429
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-534299
SN  - 1201-9712
VL  - 92
SP  - 114
EP  - 122
PB  - Elsevier Ltd.
CY  - Amsterdam [u.a.]
ER  -