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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...

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Autores principales: Luckowitsch, Marie, Rudolph, Henriette, Bochennek, Konrad, Porto, Luciana, Lehrnbecher, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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.
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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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