Clinicopathologic Characterization of Invasive Fungal Intestinal Infections in Pediatric Patients.

IF 1.3 4区医学 Q3 PATHOLOGY

Pediatric and Developmental Pathology Pub Date : 2024-08-31 DOI:10.1177/10935266241272564

Muhammad Shaheen, Guang-Sheng Lei, Ryan F Relich, Iván A González

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Abstract

Background: Invasive fungal intestinal infections are rare in pediatric patients with limited studies reported to date.

Methods: Retrospective study of invasive intestinal fungal infections in pediatric patients. For fungal specification, 18S rRNA gene PCR was performed using formalin-fixed paraffin-embedded tissues.

Results: A total of 19 cases from 18 patients were included (13 males, 72%) with a median age of 20 days (8 days-14 years). About 13 patients (72%) presented within 67 days of birth and 11 patients (61%) were premature and 14 patients (78%) had a significant medical history. The most common location was the jejunum/ileum (56%) followed by the right colon and terminal ileum (22%). In 10 patients, the fungal elements were seen in the mucosa with 3 extending into the submucosa, and only 3 patients showed full-thickness involvement. Tissue necrosis and angioinvasion were seen in 13 (72%) and 8 (44%) patients, respectively. Morphologically, organisms consistent with Candida spp. were seen in 17 patients and with a mucoraceous mold in 1 patient. A 18S rRNA gene sequencing performed in 18 cases identified Candida dubliniensis in 16 cases and Candida spp. in 2 cases. During the study follow-up period, 56% of the patients died.

Conclusion: In our experience, most cases were due to Candida spp. and predominantly in premature infants and associated with poor outcomes.

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小儿侵袭性真菌肠道感染的临床病理学特征。

背景：侵袭性真菌肠道感染在儿童患者中很少见：侵袭性真菌肠道感染在儿科患者中非常罕见，迄今为止相关研究报道有限：方法：对儿科患者侵袭性肠道真菌感染进行回顾性研究。采用福尔马林固定石蜡包埋组织进行 18S rRNA 基因 PCR 检测真菌规格：共纳入 18 名患者的 19 个病例（13 名男性，72%），中位年龄为 20 天（8 天-14 岁）。约 13 名患者（72%）在出生 67 天内发病，11 名患者（61%）为早产儿，14 名患者（78%）有重要病史。最常见的部位是空肠/回肠（56%），其次是右结肠和回肠末端（22%）。在 10 名患者中，真菌成分出现在粘膜上，其中 3 名患者的真菌成分延伸至粘膜下层，只有 3 名患者的真菌成分全层受累。分别有 13 例（72%）和 8 例（44%）患者出现组织坏死和血管侵犯。从形态上看，17 名患者的病原体与念珠菌属一致，1 名患者的病原体与粘液霉菌一致。对 18 例患者进行了 18S rRNA 基因测序，结果显示 16 例为杜布林念珠菌，2 例为念珠菌属。在随访期间，56%的患者死亡：根据我们的经验，大多数病例都是由念珠菌属引起的，主要发生在早产儿身上，且预后较差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric and Developmental Pathology 医学-病理学

CiteScore

3.70

自引率

5.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal covers the spectrum of disorders of early development (including embryology, placentology, and teratology), gestational and perinatal diseases, and all diseases of childhood. Studies may be in any field of experimental, anatomic, or clinical pathology, including molecular pathology. Case reports are published only if they provide new insights into disease mechanisms or new information.