Seidel, Danila, Hassler, Angela, Salmanton-Garcia, Jon ORCID: 0000-0002-6766-8297, Koehler, Philipp ORCID: 0000-0002-7386-7495, Mellinghoff, Sibylle C., Carlesse, Fabianne, Cheng, Matthew P., Falces-Romero, Iker, Herbrecht, Raoul ORCID: 0000-0002-9381-4876, Jover Saenz, Alfredo, Klimko, Nikolai, Mares, Mihai, Lass-Floerl, Cornelia, Soler-Palacin, Pere, Wisplinghoff, Hilmar, Cornely, Oliver A., Pana, Zoi and Lehrnbecher, Thomas (2020). Invasive Scedosporium spp. and Lomentospora prolificans infections in pediatric patients: Analysis of 55 cases from FungiScope (R) and the literature. Int. J. Infect. Dis., 92. S. 114 - 123. OXFORD: ELSEVIER SCI LTD. ISSN 1878-3511

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Abstract

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 (R) 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. (C) 2019 University Hospital of Cologne. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Seidel, DanilaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hassler, AngelaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Salmanton-Garcia, JonUNSPECIFIEDorcid.org/0000-0002-6766-8297UNSPECIFIED
Koehler, PhilippUNSPECIFIEDorcid.org/0000-0002-7386-7495UNSPECIFIED
Mellinghoff, Sibylle C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carlesse, FabianneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cheng, Matthew P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Falces-Romero, IkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herbrecht, RaoulUNSPECIFIEDorcid.org/0000-0002-9381-4876UNSPECIFIED
Jover Saenz, AlfredoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klimko, NikolaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mares, MihaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lass-Floerl, CorneliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Soler-Palacin, PereUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wisplinghoff, HilmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornely, Oliver A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pana, ZoiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lehrnbecher, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-342772
DOI: 10.1016/j.ijid.2019.12.017
Journal or Publication Title: Int. J. Infect. Dis.
Volume: 92
Page Range: S. 114 - 123
Date: 2020
Publisher: ELSEVIER SCI LTD
Place of Publication: OXFORD
ISSN: 1878-3511
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CHRONIC GRANULOMATOUS-DISEASE; LIPOSOMAL AMPHOTERICIN-B; PSEUDALLESCHERIA-BOYDII; FUNGAL-INFECTIONS; BRAIN-ABSCESS; APIOSPERMUM; CHILD; VORICONAZOLE; OSTEOMYELITIS; THERAPYMultiple languages
Infectious DiseasesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34277

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