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Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment
The incidence of invasive mold disease (IMD) has significantly increased over the last decades, and IMD of the central nervous system (CNS) is a particularly severe form of this infection. Solid data on the incidence of CNS IMD in the pediatric setting are lacking, in which Aspergillus spp. is the m...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996787/ https://www.ncbi.nlm.nih.gov/pubmed/33652605 http://dx.doi.org/10.3390/jof7030168 |
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author | Luckowitsch, Marie Rudolph, Henriette Bochennek, Konrad Porto, Luciana Lehrnbecher, Thomas |
author_facet | Luckowitsch, Marie Rudolph, Henriette Bochennek, Konrad Porto, Luciana Lehrnbecher, Thomas |
author_sort | Luckowitsch, Marie |
collection | PubMed |
description | The incidence of invasive mold disease (IMD) has significantly increased over the last decades, and IMD of the central nervous system (CNS) is a particularly severe form of this infection. Solid data on the incidence of CNS IMD in the pediatric setting are lacking, in which Aspergillus spp. is the most prevalent pathogen, followed by mucorales. CNS IMD is difficult to diagnose, and although imaging tools such as magnetic resonance imaging have considerably improved, these techniques are still unspecific. As microscopy and culture have a low sensitivity, non-culture-based assays such as the detection of fungal antigens (e.g., galactomannan or beta-D-glucan) or the detection of fungal nucleic acids by molecular assays need to be validated in children with suspected CNS IMD. New and potent antifungal compounds helped to improve outcome of CNS IMD, but not all agents are approved for children and a pediatric dosage has not been established. Therefore, studies have to rapidly evaluate dosage, safety and efficacy of antifungal compounds in the pediatric setting. This review will summarize the current knowledge on diagnostic tools and on the management of CNS IMD with a focus on pediatric patients. |
format | Online Article Text |
id | pubmed-7996787 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79967872021-03-27 Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment Luckowitsch, Marie Rudolph, Henriette Bochennek, Konrad Porto, Luciana Lehrnbecher, Thomas J Fungi (Basel) Review The incidence of invasive mold disease (IMD) has significantly increased over the last decades, and IMD of the central nervous system (CNS) is a particularly severe form of this infection. Solid data on the incidence of CNS IMD in the pediatric setting are lacking, in which Aspergillus spp. is the most prevalent pathogen, followed by mucorales. CNS IMD is difficult to diagnose, and although imaging tools such as magnetic resonance imaging have considerably improved, these techniques are still unspecific. As microscopy and culture have a low sensitivity, non-culture-based assays such as the detection of fungal antigens (e.g., galactomannan or beta-D-glucan) or the detection of fungal nucleic acids by molecular assays need to be validated in children with suspected CNS IMD. New and potent antifungal compounds helped to improve outcome of CNS IMD, but not all agents are approved for children and a pediatric dosage has not been established. Therefore, studies have to rapidly evaluate dosage, safety and efficacy of antifungal compounds in the pediatric setting. This review will summarize the current knowledge on diagnostic tools and on the management of CNS IMD with a focus on pediatric patients. MDPI 2021-02-26 /pmc/articles/PMC7996787/ /pubmed/33652605 http://dx.doi.org/10.3390/jof7030168 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ). |
spellingShingle | Review Luckowitsch, Marie Rudolph, Henriette Bochennek, Konrad Porto, Luciana Lehrnbecher, Thomas Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment |
title | Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment |
title_full | Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment |
title_fullStr | Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment |
title_full_unstemmed | Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment |
title_short | Central Nervous System Mold Infections in Children with Hematological Malignancies: Advances in Diagnosis and Treatment |
title_sort | central nervous system mold infections in children with hematological malignancies: advances in diagnosis and treatment |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996787/ https://www.ncbi.nlm.nih.gov/pubmed/33652605 http://dx.doi.org/10.3390/jof7030168 |
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