Clinicopathologic Characterization of Invasive Fungal Intestinal Infections in Pediatric Patients
Clinicopathologic Characterization of Invasive Fungal Intestinal Infections in Pediatric Patients

Clinicopathologic Characterization of Invasive Fungal Intestinal Infections in Pediatric Patients

Pediatr Dev Pathol. 2024 Aug 31:10935266241272564. doi: 10.1177/10935266241272564. Online ahead of print.

ABSTRACT

BACKGROUND: Invasive fungal intestinal infections are rare in pediatric patients with limited studies reported to date.

METHODS: Retrospective study of invasive intestinal fungal infections in pediatric patients. For fungal specification, 18S rRNA gene PCR was performed using formalin-fixed paraffin-embedded tissues.

RESULTS: A total of 19 cases from 18 patients were included (13 males, 72%) with a median age of 20 days (8 days-14 years). About 13 patients (72%) presented within 67 days of birth and 11 patients (61%) were premature and 14 patients (78%) had a significant medical history. The most common location was the jejunum/ileum (56%) followed by the right colon and terminal ileum (22%). In 10 patients, the fungal elements were seen in the mucosa with 3 extending into the submucosa, and only 3 patients showed full-thickness involvement. Tissue necrosis and angioinvasion were seen in 13 (72%) and 8 (44%) patients, respectively. Morphologically, organisms consistent with Candida spp. were seen in 17 patients and with a mucoraceous mold in 1 patient. A 18S rRNA gene sequencing performed in 18 cases identified Candida dubliniensis in 16 cases and Candida spp. in 2 cases. During the study follow-up period, 56% of the patients died.

CONCLUSION: In our experience, most cases were due to Candida spp. and predominantly in premature infants and associated with poor outcomes.

PMID:39215520 | DOI:10.1177/10935266241272564