Invasive Pulmonary Aspergillosis in the Paediatric Patient

In children with primary or acquired immunodeficiencies affecting the function of granulocytes, invasive aspergillosis (IA) is a feared and serious infectious complication with a high case-fatality rate. The clinical disease phenotypes closely resemble that seen in adults with a predominance of invasive pulmonary aspergillosis (IPA). Risk factors associated with IPA and its clinical presentation in children are not different from adults. Concerning the biology and treatment of underlying conditions and comorbidities, the Aspergillus species causing IPA and the usefulness of diagnostic tools, the adult and paediatric patient population do diverge. Management guidelines are derived from phase III clinical trials in adults. Consideration needs to be given to the pharmacology and dosing of systemic antifungal agents in children.