PMID- 36795580
OWN - NLM
STAT- MEDLINE
DCOM- 20230414
LR  - 20230913
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Linking)
VI  - 42
IP  - 5
DP  - 2023 May 1
TI  - Chronic Disseminated Candidiasis in Children and the Role of Corticosteroids 
      Therapy.
PG  - e146-e151
LID - 10.1097/INF.0000000000003859 [doi]
AB  - BACKGROUND: Little is known about chronic disseminated candidiasis (CDC) in 
      children. This study was done to describe the epidemiology, risk factors and 
      outcome of CDC in children managed at Sultan Qaboos University Hospital (SQUH), 
      Oman, and to describe the role of corticosteroids in the management of immune 
      reconstitution inflammatory syndrome (IRIS) complicating CDC. METHODS: We 
      retrospectively reported demographic, clinical and laboratory data of all 
      children managed in our center for CDC between January 2013 and December 2021. In 
      addition, we discuss the available literature on the role of corticosteroids for 
      management of CDC-related IRIS in children since 2005. RESULTS: Between January 
      2013 and December 2021, 36 immunocompromised children were diagnosed with 
      invasive fungal infection at our center, of whom 6 had CDC (all with acute 
      leukemia). Their median age was 5.75 years. Prolonged fever despite 
      broad-spectrum antibiotics (6/6) followed by skin rash (4/6) were the most common 
      clinical features of CDC. Four children grew Candida tropicalis from blood or 
      skin. CDC-related IRIS was documented in 5 children (83%) and 2 received 
      corticosteroids. Our literature review revealed that 28 children were managed 
      with corticosteroids for CDC-related IRIS since 2005. The majority of these 
      children had defervescence of fever within 48 hours. Prednisolone of 
      1-2 mg/kg/day for 2-6 weeks was the most common regimen used. No major side 
      effects reported in these patients. CONCLUSION: CDC is more common in children 
      with acute leukemia and CDC-related IRIS is not uncommon. Corticosteroid therapy 
      looks effective and safe as adjunctive therapy for CDC-related IRIS.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Al Yazidi, Laila S
AU  - Al Yazidi LS
AUID- ORCID: 0000-0002-0459-3726
AD  - From the Department of Child Health, Sultan Qaboos University Hospital, Muscat, 
      Oman.
FAU - Elsidig, Nagi
AU  - Elsidig N
AD  - From the Department of Child Health, Sultan Qaboos University Hospital, Muscat, 
      Oman.
FAU - Wali, Yasser
AU  - Wali Y
AD  - From the Department of Child Health, Sultan Qaboos University Hospital, Muscat, 
      Oman.
FAU - Nazir, Hanan
AU  - Nazir H
AD  - Department of Pediatrics, Alexandria Faculty of Medicine, Alexandria, Egypt.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230216
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
RN  - 0 (Antifungal Agents)
RN  - 0 (Adrenal Cortex Hormones)
RN  - Systemic candidiasis
SB  - IM
MH  - Humans
MH  - Child
MH  - Child, Preschool
MH  - Retrospective Studies
MH  - Antifungal Agents/therapeutic use
MH  - Chronic Disease
MH  - *Candidiasis/drug therapy
MH  - Fever/microbiology
MH  - *Leukemia, Myeloid, Acute/complications
MH  - Acute Disease
MH  - Adrenal Cortex Hormones/adverse effects
COIS- The authors have no funding or conflicts of interest to disclose.
EDAT- 2023/02/17 06:00
MHDA- 2023/04/14 06:41
CRDT- 2023/02/16 12:43
PHST- 2023/04/14 06:41 [medline]
PHST- 2023/02/17 06:00 [pubmed]
PHST- 2023/02/16 12:43 [entrez]
AID - 00006454-202305000-00016 [pii]
AID - 10.1097/INF.0000000000003859 [doi]
PST - ppublish
SO  - Pediatr Infect Dis J. 2023 May 1;42(5):e146-e151. doi: 
      10.1097/INF.0000000000003859. Epub 2023 Feb 16.