Cutaneous Aspergillosis in Children and Adolescents

Abstract

This is a general review of the disease in this article, especially of the clinical features, diagnosis, new treatments and preventive measures. Diagnostic methods in pediatric population to confirm the diagnosis of aspergillosis and typify the etiologic agent are based on the use of molecular biology through PCR techniques. Currently, the treatment of choice for cases of primary cutaneous aspergillosis is liposomal amphotericin B or itraconazole alone or synergistically, uuse of voriconazole, posaconazole, or caspofungin is recommended as a second-line management. Cutaneous aspergillosis is a rare condition in immunocompetent individuals and is more frequently observed in immunosuppressed patients. Considering the pediatric population as a specific case, it more commonly occurs in individuals suffering from a hemato-oncological disease. Asperillus flavus and A. fumigatus are the main pathogens responsible for primary and secondary (invasive) cutaneous aspergillosis, respectively. The clinical picture develops after direct inoculation of the fungus by contiguity of infected cavities or secondary to the presence of a distant mycotic focus that reaches the skin and its annexes by hematogenous dissemination. Owing to the rapid progression of the disease, a delay in initiating proper management impacts patient mortality. In case of children and adolescents, clinical suspicion in individuals with risk factors should be the main argument for starting pharmacological management in a timely manner.