Central nervous system mold infections in children with hematological malignancies: advances in diagnosis and treatment

  • The incidence of invasive mold disease (IMD) has significantly increased over the last decades, and IMD of the central nervous system (CNS) is a particularly severe form of this infection. Solid data on the incidence of CNS IMD in the pediatric setting are lacking, in which Aspergillus spp. is the most prevalent pathogen, followed by mucorales. CNS IMD is difficult to diagnose, and although imaging tools such as magnetic resonance imaging have considerably improved, these techniques are still unspecific. As microscopy and culture have a low sensitivity, non-culture-based assays such as the detection of fungal antigens (e.g., galactomannan or beta-D-glucan) or the detection of fungal nucleic acids by molecular assays need to be validated in children with suspected CNS IMD. New and potent antifungal compounds helped to improve outcome of CNS IMD, but not all agents are approved for children and a pediatric dosage has not been established. Therefore, studies have to rapidly evaluate dosage, safety and efficacy of antifungal compounds in the pediatric setting. This review will summarize the current knowledge on diagnostic tools and on the management of CNS IMD with a focus on pediatric patients.
Author:Marie Luckowitsch, Henriette Rudolph, Konrad BochennekORCiDGND, Luciana PortoORCiDGND, Thomas LehrnbecherORCiDGND
Parent Title (English):Journal of Fungi
Place of publication:Basel
Document Type:Article
Date of Publication (online):2021/02/26
Date of first Publication:2021/02/26
Publishing Institution:Universit├Ątsbibliothek Johann Christian Senckenberg
Release Date:2021/05/26
Tag:Aspergillus; central nervous system; child; invasive fungal disease; mold; mucormycetes
Issue:3, art. 168
Page Number:18
First Page:1
Last Page:18
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0