Objective: To investigate the clinical features of invasive fungal disease (IFD) in children without underlying diseases.
Methods: The clinical data of 49 children without underlying diseases who were diagnosed with IFD were retrospectively studied.
Results: Fungal pathogens were detected in 37 (76%) out of 49 patients, including Cryptococcus neoformans (17 children, 46%), Candida albicans (10 children, 27%), Aspergillus (3 children, 8%), and Candida parapsilosis (3 children, 8%). Fungal pneumonia (17 children, 46%) was the most commonly seen disease, with Candida albicans as the major pathogen (9 children, 53%). The 49 children had at least one high-risk factor for infection, including the use of antibiotics, a long length of hospital stay, and invasive procedures. Of all the children, 82% did not respond well to antibiotic treatment or experienced recurrent pyrexia. Among the 24 children who underwent G tests, 17 (71%) showed positive results. All the children were given antifungal therapy, and among these children, 37 (75%)were cured, 3 (6%) were still in the treatment, 5 (10%) died, and 4 (8%) were lost to follow-up.
Conclusions: In IFD children without underlying diseases, Cryptococcus neoformans and Candida are the main pathogens, and lung infection is the most common disease. Long-term use of high-dose antibiotics may be an important risk factor for fungal infection. The IFD children without underlying diseases are sensitive to antifungal drugs and have a satisfactory prognosis.
目的: 探讨无基础疾病儿童侵袭性真菌病（IFD）的临床特点。
方法: 回顾性分析49例无基础疾病侵袭性真菌病患儿的临床资料。
结果: 无基础疾病侵袭性真菌病儿童的病原检出率为76%（37/49），其中新型隐球菌（17例，46%）、白色假丝酵母菌（10例，27%）、曲霉菌及近平滑假丝酵母菌（各3例，均占8%）为最常见的病原。真菌性肺炎最多见（17例，46%），病原以白色假丝酵母菌为主（9例，53%）。49例患儿均存在至少一项感染高危因素，主要为抗生素使用、长时间住院以及侵袭性操作。行G试验检查的24例中17例阳性（71%）。49例患儿均接受抗真菌治疗，37例（75%）治愈，3例（6%）仍在治疗中，5例（10%）死亡，4例（8%）失访。
结论: 对于无基础疾病的IFD患儿，新型隐球菌、念珠菌为其主要病原，肺部感染最为多见。长期大量使用抗生素是较突出危险因素。无基础疾病的IFD患儿对于抗真菌药物敏感，预后较好。