ArticleMycopathologia2026
Epidemiology, Clinical Features, and Outcomes of Proven Invasive Fungal Infections in Pediatric Patients.
Article in Mycopathologia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
backgroundInvasive fungal infections (IFIs) cause significant morbidity and mortality in immunocompromised pediatric patients; systematic data comparing mold- and yeast-related infections remain limited.
objectivesTo evaluate epidemiology, clinical features, antifungal treatment, and outcomes of proven infectious fungal infections (IFIs) in immunocompromised children, comparing mold and yeast infections. PATIENTS/
methodsThis single-center retrospective study included 65 immunocompromised patients aged ≤ 18 years with proven IFIs diagnosed by the European Organization for Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) criteria.
resultsOf 65 patients (75.4% male; median age 62 months), mold infections occurred in 21 (32.3%) and yeast infections in 44 (67.7%). Aspergillus spp. (n = 6) and Mucor spp. (n = 3) were common molds; Candida parapsilosis (n = 15) predominated among yeasts. ALL was more prevalent in the mold group (38.1% vs. 11.4%; p = 0.019), while other oncological malignancies predominated in the yeast group (50.0% vs. 19.0%; p = 0.017). Combination therapy (66.7% vs. 9.1%; p < 0.001), salvage therapy (52.4% vs. 27.3%; p = 0.048), and treatment duration (median 56 vs. 21 days; p < 0.001) were higher in the mold group. Mold infections showed higher rates of nodules, cavitation, and air-crescent sign on thoracic CT (p < 0.05) and greater pulmonary progression (23.8% vs. 2.3%; p = 0.011). The overall pediatric intensive care unit (PICU) admission rate was 40.0%; mechanical ventilation was more frequent in the mold group (47.6% vs. 15.9%; p = 0.007) and was identified as the sole independent predictor of IFI-attributable mortality (OR 14.5; 95% CI 3.47-60.41; p < 0.001).Overall mortality was 36.9% with no between-group difference (p = 0.892); IFI-attributable mortality was higher in the mold group (28.6% vs. 18.2%; p = 0.081).
conclusionsMold and yeast infections show distinct clinical, radiological, and therapeutic profiles in immunocompromised children, with mold infections showing greater treatment burden and higher IFI-attributable mortality.
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