TABLE 8.
Pediatric cases of osteoarticular fungal infections extracted from the various studies of the Osteoarticular Mycoses Consortiuma
| Authors (reference), yr | Type of infection | No. of pediatric patients (age [yrs]) | Underlying condition(s) (no. of cases [%]) | Mechanism(s) of infection (no. of cases) | 3 most common sites | No. of sites (no. of cases) | Clinical symptoms (no. of cases) | Therapies (no. of cases) | Outcome(s) (no. of cases) |
|---|---|---|---|---|---|---|---|---|---|
| Gamaletsou et al. (1), 2012 | Candida OM | 37 (<18) | Neonates (10), low birth wt (14), Hemato (7), HCT (2), solid tumor (2) | Hematogenous (29), contiguous (5), direct inoculation (3) | Femur (21), humorous (17), others (19) | 1 bone, (15), 2 bones (8), ≥3 bones (14) | Local (31), limitation of movement (13), fever (12), draining pus (3) | AFT (25), surgery (1), AFT + surgery (10), amphotericin (22), azoles (6), combination AFT (3) | CR (16), PR (17), R (9), D (5) |
| Gamaletsou et al. (270), 2012 | Candida AR | 40 (<18) | Neonates (11), Hemato (5), HCT (2) | Hematogenous (38), contiguous (0), direct inoculation (2) | Knee (31), hip (10), ankle (5) | 1 bone (20), 2 bones (5), ≥3 bones (15) | Pain (22), edema (31), erythema (6), limitation of movement (20), fever (7), draining pus (2) | AFT (28), surgery (0), AFT + surgery (11), debridement (4), amputation (1), drainage (5), lavage (4), amphotericin (29), azoles (9), 5-FC (14), echinocandins (2) | CR (35), PR (5), R (3), D (2) |
| Gamaletsou et al. (572), 2017 | Aspergillus AR | 4 (<18); 1 neonate and 3 children | Hemato (2), CGD (1) | Hematogenous (3) | Intervertebral sites (T1–T3), knee, ankle, carpal, hip | 1 bone (1), ≥3 bones (3) | Pain (4), tenderness (4), draining pus (1), sinus formation (1) | AFT (2), AFT + surgery (1) | CR (3), D (1) |
| Gamaletsou et al. (550), 2014 | Aspergillus OM | 37 (<18) | Hemato (9), CGD (20) | Hematogenous (23), contiguous (11), direct inoculation (3) | Ribs (12), vertebrae (11), cranium (8) | 1 bone (20), 2 bones (5), ≥3 bones (12) | Local (25), limitation of movement (5), fever (15), draining pus (8) | NR specifically in children | CR (18), PR (10), R (1), D (12) |
| Taj-Aldeen et al. (652), 2015 | Non-Aspergillus OA | 34 (≤15) | Trauma/wound (25 [73.5]), immunosuppression (16 [47]) | Direct inoculation (27), hematogenous (7) contiguous (0) | Bone (19), lower limbs (15/19); joint (18), knee (14/18) | 1 bone (21), 2 bones (4), ≥3 bones (1) | Pain (30), limitation of movement (23), fever (19), inflammation (26) | AFT + surgery (21), AFT (10), surgery (3), amphotericin (16), azoles (9), combination AFT (9) | CR (29), PR (4), D (1) |
| Taj-Aldeen et al. (736), 2017 | Mucorales OA | 1 (0.5) | Liver transplant | Contiguous | Ulna | 1 bone | NR | AFT + surgery, amphotericin, voriconazole | CR |
a
OM, osteomyelitis; AR, arthritis; OA, osteoarticular; AFT, antifungal therapy; Hemato, hematological malignancy; HCT, hematopoietic cell transplantation; CR, complete response; PR, partial response; NR, no response; R, relapsed; D, death; 5-FC, 5-fluorocytosine; CGD, chronic granulomatous disease.