Deep cutaneous fungal infections in immunocompromised children

摘要: Background Life-threatening infections from ubiquitous fungi are becoming more prevalent in adults and children because of the increased use immunosuppressive agents broad-spectrum anti-infective drugs. Extremely low birth weight premature neonates patients with a disrupted epidermal barrier also at risk. Lethality is high, particularly delayed diagnosis. As cutaneous lesions often first manifestation such infections, early recognition suspicious crucial to decrease associated morbidity mortality. The clinical features deep fungal infection (DCFI) immunocompromised deserve special attention. Objectives This study aimed characterize our pediatric DCFI, causative fungi, risk factors. Methods A medical record review was conducted DCFI treated out institution using data retrieved hospital's pathology microbiology database (1980-2008). Results In all, 26 were identified (9 girls 17 boys) ranging age 1 day 18 years (mean age: 8 years), majority whom had hematologic disorder. All immunocompromised, 90% receiving antibiotics, 50% severe neutropenia (absolute neutrophilic count ≤ 500 × 10 6 /L). Necrotic ulcers (42%) papules (34%) represented most frequent lesion morphology. Fungal species by culture 20 (87%) 23 tested observed histopathologically tested. Aspergillus 12 (44%) Candida 9 (33%). other included Fusarium (one), Exserohilum rostratum Alternaria Zygomycetes (two), Blatomycetes (one). but two received systemic antifungal therapy; wide surgical excision performed 13. Infection resolved (77%), whereas (23%) died disseminated infection. Limitations limited small number cases retrospective nature collected data. Discussion should rank high differential diagnosis any skin children. Early biopsies be for histopathology microbiological analysis, as lethality if appropriate treatment delayed.