Fungemia in children infected with the human immunodeficiency virus: New epidemiologic patterns, emerging pathogens, and improved outcome with antifungal therapy

Thomas J. Walsh, Corina Gonzalez, Emmanuel Roilides, Brigitta U. Mueller, Nasr Ali, Linda L. Lewis, Trish O. Whitcomb, Doris J. Marshall, Philip A. Pizzo

Research output: Contribution to journalArticle

Abstract

We characterized 27 episodes of fungemia in 22 children infected with the human immunodeficiency virus (HIV). Fungemia in these patients presented as a community-acquired infection in the setting of outpatient total parenteral nutrition or intravenous antibiotic therapy through a chronically indwelling central venous catheter (CVC). Fungemia developed only in patients with CVCs (P <.001). Non-albicans Candida species, Torulopsis glabrata, Rhodotorula rubra, and Bipolaris spicifera constituted 52% of all causes. Fungemia was detected early, within a median of 2.4 days after the onset of new fever, which permitted prompt administration of amphotericin B (mean dosage, 0.7 mg/[kg A day]; median duration, 19 days). CVCs were removed in 23 (85%) of the episodes. We conclude that fungemia in HIV-infected children often presents as a community-acquired infection, is frequently due to newly emerging opportunistic fungi, and can be managed, with a high level of success (95% survival with no posttherapeutic sequelae), by early diagnosis, prompt initiation of amphotericin B therapy, and removal of the CVC.

Original languageEnglish (US)
Pages (from-to)900-906
Number of pages7
JournalClinical Infectious Diseases
Volume20
Issue number4
DOIs
StatePublished - Apr 1995

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Walsh, T. J., Gonzalez, C., Roilides, E., Mueller, B. U., Ali, N., Lewis, L. L., Whitcomb, T. O., Marshall, D. J., & Pizzo, P. A. (1995). Fungemia in children infected with the human immunodeficiency virus: New epidemiologic patterns, emerging pathogens, and improved outcome with antifungal therapy. Clinical Infectious Diseases, 20(4), 900-906. https://doi.org/10.1093/clinids/20.4.900