Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People's Republic of China.
The Department of Dermatology, The First Affiliated Hospital of Guangxi Medical University, No 22, Shuang Yong Road, Nanning, 530022, People's Republic of China.
Mycopathologia. 2019 Dec;184(6):735-745. doi: 10.1007/s11046-019-00373-4. Epub 2019 Aug 31.
Knowledge about the clinical and laboratory characteristics and prognosis of Talaromyces marneffei infection in children is limited. A retrospective study was conducted on pediatric patients with disseminated T. marneffei infection in a clinical setting. Extracted data included demographic information (age and sex), clinical features, laboratory findings, treatment, and prognosis. Eleven HIV-negative children were enrolled. The male/female ratio was 8:3. The median age of onset was 17.5 months (3.5-84 months). The mortality rate in these children was 36.36% (4/11). Seven children had underlying diseases. All of the children had multiple immunoglobulin abnormalities and immune cell decline. Ten children received voriconazole treatment, and most of the children (7/10) had a complete response to therapy at primary and long-term follow-up assessment; only three children died of talaromycosis. One patient recovered from talaromycosis but died of leukemia. The child who received itraconazole treatment also showed clinical improvement. No adverse events associated with antifungal therapies were recorded during and after the treatment. Talaromycosis is an indicator disease for undiagnosed severe immunodeficiencies in children. Awareness of mycoses in children by pediatricians may prompt diagnosis and timely treatment. Voriconazole is an effective, well-tolerated therapeutic option for disseminated T. marneffei infection in non-HIV-infected children.
关于儿童马尔尼菲青霉感染的临床和实验室特征及预后的知识有限。对临床环境中患有播散性马尔尼菲青霉感染的儿科患者进行了回顾性研究。提取的数据包括人口统计学信息(年龄和性别)、临床特征、实验室发现、治疗和预后。共纳入 11 例 HIV 阴性儿童。男女比例为 8:3。发病中位年龄为 17.5 个月(3.5-84 个月)。这些儿童的死亡率为 36.36%(4/11)。7 例儿童有基础疾病。所有儿童均存在多种免疫球蛋白异常和免疫细胞下降。10 例儿童接受伏立康唑治疗,大多数儿童(7/10)在初次和长期随访评估时对治疗有完全反应;仅 3 例儿童死于马尔尼菲青霉病。1 例儿童从马尔尼菲青霉病中康复,但死于白血病。接受伊曲康唑治疗的患儿也表现出临床改善。在治疗期间和治疗后均未记录与抗真菌治疗相关的不良事件。马尔尼菲青霉病是儿童未确诊严重免疫缺陷的指示性疾病。儿科医生对儿童真菌病的认识可能会促使及时诊断和治疗。伏立康唑是治疗非 HIV 感染儿童播散性马尔尼菲青霉感染的有效、耐受性良好的治疗选择。