Retrospective Investigation of Pediatric Histoplasmosis Diagnosed at a Tertiary Children's Hospital in an Endemic Area Over 11 Years.
Document Type
Article
Publication Date
3-12-2025
Identifier
DOI: 10.1093/jpids/piaf007
Abstract
BACKGROUND: Most histoplasmosis data are from adults. We describe pediatric histoplasmosis diagnosed at a tertiary pediatric care center in an endemic area.
METHODS: We performed a retrospective chart review of patients birth-18 years seen in our institution (January 1, 2010 to August 15, 2022) with histoplasmosis identified by International Classification of Disease codes. We performed descriptive and univariate analyses of demographic, historical, clinical, laboratory, and treatment data.
RESULTS: Of 122 patients, 26 had disseminated histoplasmosis (DH), 71 pulmonary/thoracic (P/T) disease, 21 had histoplasmosis as an incidental finding, and 4 were classified as other. Median age was 14 years (range 0.3-18.7 years); most were non-Hispanic White (70.5%) and city dwellers (77.1%). We noted neither seasonality nor disease category differences for age, race and ethnicity, residence, or environmental factors. Compared to P/T, DH more frequently had complex chronic conditions (73.1% vs 12.7%, P < .001), fever (88.5% vs 52.1%, P < .001), fatigue (76.9% vs 46.5%, P = .01), vomiting (53.8% vs 25.3%, P = .01), anemia (hemoglobin median 10.05 vs 12.5 g/dL, P < .001), elevated sedimentation rate values (median 31 vs 29 mm/h, P = .02), blood and urine Histoplasma antigen detection (63.6/84.6% vs 20.0/14.8%, P < .001), and antifungal treatment (100% vs 70.4%, P < .001). Patients with DH had longer antifungal treatment courses (399 vs 84 days, P < .001). Exposures were rarely recorded, but the most common was chickens. Chest radiographs were less likely to show adenopathy in DH compared to P/T (8.7% vs 55%, P < .001).
CONCLUSIONS: Presentations, risk factors, diagnostics use/results, and therapy for pediatric histoplasmosis most often parallel those in adults.
Journal Title
J Pediatric Infect Dis Soc
Volume
14
Issue
3
MeSH Keywords
Humans; Histoplasmosis; Retrospective Studies; Adolescent; Child; Child, Preschool; Male; Female; Infant; Tertiary Care Centers; Hospitals, Pediatric; Endemic Diseases; Antifungal Agents
PubMed ID
39945765
Keywords
Histoplasma capsulatum; endemic mycoses; histoplasmosis; pediatric
Recommended Citation
Al-Tahhan L, Harrison CJ, Lee BR, El Feghaly RE. Retrospective Investigation of Pediatric Histoplasmosis Diagnosed at a Tertiary Children's Hospital in an Endemic Area Over 11 Years. J Pediatric Infect Dis Soc. 2025;14(3):piaf007. doi:10.1093/jpids/piaf007
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