16/11/2019
Invasive fungal diseases (IFDs) have become an importantcause of morbidity and mortality in immunosuppressedpatients, especially those with cancer and/or undergoinghematopoietic stem cell transplantation (HSCT).1,2Pediatric patients are equally susceptible to IFD com-pared to the adult population. However, there are relevantdifferences in the physiology, presence of comorbidities,pharmacokinetic and tolerance to antifungals, treatment reg-imens, underlying diseases evolution, populations at risk andprognosis of fungal infections. Therefore, the extrapolationof clinical practices consolidated in the adult population forchildren is sometimes inappropriate, making it necessary tocreate specific guidelines for the clinical management of IFDoptimized for pediatric patients assisted in our country. Inorder to propose algorithms for early diagnosis and best clin-ical management of IFDs in pediatric patients we reviewedall major multicenter studies designed to characterize theepidemiology of IFDs in children with cancer, as well as allrandomized clinical trials addressing empirical and targetedantifungal therapy. In the absence of randomized clinicaltrials, the best evidence available to support the recommen-dations were selected.
