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Órgano Oficial de la Sociedad
Latinoamericana de lnfectología Pediátrica.
Órgano de la Asociación Mexicana de
Infectología Pediátrica, A.C.
Órgano difusor de la Sociedad Española
de lnfectología

2024, Number 1

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Rev Latin Infect Pediatr 2024; 37 (1)

Update on the diagnosis of pediatric fungal endocarditis and its limitations in Latin America

Solé ML, Hernández QCJ, Sajmolo RIL

Language: Spanish
References: 74
Page: 44-56
PDF size: 327.12 Kb.


ABSTRACT

Fungal Endocarditis (FE) presents a diagnostic challenge due to its non-specific symptoms. It is suspected in patients who do not experience clinical improvement despite treatment with antibiotics targeting the host or the pathogenic fungus. For an effective approach, it is crucial to have a multidisciplinary team. The Modified Duke Criteria do not include specific tests for fungi, which limits their usefulness in FE. Microbiological cultures, especially blood cultures, are the standard for identifying the causative agent. Tissue cultures are considered an alternative when blood cultures yield negative results. Serological tests such as galactomannan, mannan, anti-mannan, and β-1-3-D-glucan have shown sensitivity and specificity in detecting pathogenic fungi. In the pediatric field, their effectiveness is still being investigated. Molecular techniques offer fast and precise results in fungal identification, although they are in the developmental phase for pediatric FE. In Latin America, pediatric FE is underdiagnosed due to a lack of resources and technology in laboratories. Mostly, reliance is placed on tissue cultures and clinical assessment for diagnosis.


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