Abstract：
BACKGROUND: Phaeohyphomycosis is an infection caused by pigmented fungi, which can be life-threatening in immunocompromised hosts and in disseminated disease. In adults with disseminated disease, mortality is as high as 79%. Data in children are derived from case reports and series. We conducted this study to review the characteristics of phaeohyphomycoses in children.
METHODS: We conducted this study following the PRISMA 2020 guideline for reporting systematic reviews. We performed a review of the reported cases of pediatric phaeohyphomycoses in core bibliographic databases published in the English and Spanish language, between June 1977 and October 2021. We included all eligible cases in patients <18 years to determine the clinical characteristics, diagnosis, treatment, and outcomes.
RESULTS: A total of 130 cases were reviewed. The mean age was 8 years. The most common underlying conditions and risk factors included hematologic malignancies (32.5%), neutropenia (26.9%), steroid therapy (24.6%), trauma or surgery (23.1%), and children that received a transplant (14.6%). The most common presentation was localized infection (61.5%); skin and soft tissue infections were the most prevalent (25.4%). Exserohilum spp (20.8%) and Exophiala spp (17.7%) were the most common organisms isolated. Antifungal therapy remains as the most frequent treatment (87%). Overall mortality rate was 22.3% (localized 13.7% vs disseminated 37.3%).
CONCLUSIONS: The findings of this review suggest that phaeohyphomycoses in children have a better outcome compared to adults. We report a lower mortality rate in children when compared with adults in disseminated infection (37.3% vs 79%) and CNS infection (50% vs 60-70%). However, there is a wide variation in mortality rates according to the infection site, treatment, and underlying conditions. Prospective studies are needed.
METHODS: We conducted this study following the PRISMA 2020 guideline for reporting systematic reviews. We performed a review of the reported cases of pediatric phaeohyphomycoses in core bibliographic databases published in the English and Spanish language, between June 1977 and October 2021. We included all eligible cases in patients <18 years to determine the clinical characteristics, diagnosis, treatment, and outcomes.
RESULTS: A total of 130 cases were reviewed. The mean age was 8 years. The most common underlying conditions and risk factors included hematologic malignancies (32.5%), neutropenia (26.9%), steroid therapy (24.6%), trauma or surgery (23.1%), and children that received a transplant (14.6%). The most common presentation was localized infection (61.5%); skin and soft tissue infections were the most prevalent (25.4%). Exserohilum spp (20.8%) and Exophiala spp (17.7%) were the most common organisms isolated. Antifungal therapy remains as the most frequent treatment (87%). Overall mortality rate was 22.3% (localized 13.7% vs disseminated 37.3%).
CONCLUSIONS: The findings of this review suggest that phaeohyphomycoses in children have a better outcome compared to adults. We report a lower mortality rate in children when compared with adults in disseminated infection (37.3% vs 79%) and CNS infection (50% vs 60-70%). However, there is a wide variation in mortality rates according to the infection site, treatment, and underlying conditions. Prospective studies are needed.
摘要：
背景：毛真菌病是由色素真菌引起的感染，在免疫受损的宿主和播散性疾病中可能危及生命。在患有播散性疾病的成年人中，死亡率高达79%。儿童数据来自病例报告和系列。我们进行了这项研究，以回顾儿童的phaeophophycoses的特征。
方法：我们遵循PRISMA2020报告系统评价的指南进行了这项研究。我们在以英语和西班牙语出版的核心书目数据库中对报道的小儿斑纹菌病病例进行了审查，1977年6月至2021年10月。我们纳入了18岁以下患者的所有合格病例，以确定临床特征，诊断,治疗,和结果。
结果：共130例。平均年龄为8岁。最常见的潜在疾病和危险因素包括血液系统恶性肿瘤（32.5%）。中性粒细胞减少症（26.9%），类固醇治疗（24.6%），外伤或手术(23.1%)，和接受移植的儿童(14.6%)。最常见的表现是局部感染（61.5％）；皮肤和软组织感染最普遍（25.4％）。Exserohilumspp（20.8％）和Exophialaspp（17.7％）是最常见的分离生物。抗真菌治疗仍然是最常见的治疗方法（87％）。总死亡率为22.3%(局部13.7%vs播散37.3%)。
结论：本综述的研究结果表明，儿童的pheophyphomecoses比成人有更好的结果。我们报告说，与成年人相比，儿童在播散性感染（37.3％vs79％）和中枢神经系统感染（50％vs60-70％）中的死亡率较低。然而,根据感染部位的不同，死亡率差异很大，治疗,和潜在条件。需要前瞻性研究。
方法：我们遵循PRISMA2020报告系统评价的指南进行了这项研究。我们在以英语和西班牙语出版的核心书目数据库中对报道的小儿斑纹菌病病例进行了审查，1977年6月至2021年10月。我们纳入了18岁以下患者的所有合格病例，以确定临床特征，诊断,治疗,和结果。
结果：共130例。平均年龄为8岁。最常见的潜在疾病和危险因素包括血液系统恶性肿瘤（32.5%）。中性粒细胞减少症（26.9%），类固醇治疗（24.6%），外伤或手术(23.1%)，和接受移植的儿童(14.6%)。最常见的表现是局部感染（61.5％）；皮肤和软组织感染最普遍（25.4％）。Exserohilumspp（20.8％）和Exophialaspp（17.7％）是最常见的分离生物。抗真菌治疗仍然是最常见的治疗方法（87％）。总死亡率为22.3%(局部13.7%vs播散37.3%)。
结论：本综述的研究结果表明，儿童的pheophyphomecoses比成人有更好的结果。我们报告说，与成年人相比，儿童在播散性感染（37.3％vs79％）和中枢神经系统感染（50％vs60-70％）中的死亡率较低。然而,根据感染部位的不同，死亡率差异很大，治疗,和潜在条件。需要前瞻性研究。
