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National epidemiology of endemic fungal inefctions in children

Jaclyn H. Chu, MHS1, Theoklis E. Zaoutis, MD1, Jesse Argon2, and Chris Feudtner, MD, PhD, MPH2. (1) Division of Infectious Diseases, Children's Hospital of Philadelphia, 3535 Market Street, 15th Floor, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, 267-426-5629, chuj@email.chop.edu, (2) Division of General Pediatrics, Children's Hospital of Philadelphia, 3535 Market Street, 15th Floor, The Children's Hospital of Philadelphia, Philadelphia, PA 19104

Background: The national incidence and epidemiology of endemic fungal infections in children have not been fully reported and have only been discussed in smaller case studies. Objectives: To determine the incidence of endemic fungal infections among children hospitalized in the U.S. and to report demographic and regional characteristics of those infected. Design/Methods: A cross-sectional study using the 2000 Kidsí Inpatient Database, an 80% weighted sample of all hospital pediatric admissions in 27 states during 2000. Endemic fungal infections and comorbidities were defined by ICD-9-CM codes. Results: The estimated national incidence of histoplasmosis in children was 3 cases per 100,000 pediatric admissions (95% CI: 1, 4), 2/100,000 (95% CI: 1, 4) for blastomycosis, and 3/100,000 (95% CI: 1, 6) for coccidioidomycosis. There was one reported case of paracoccidioidomycosis. The highest regional incidences of histoplasmosis and blastomycosis occurred in the Midwest, with rates of 5 (95% CI: 0, 11) and 10/100,000 (95% CI: 2, 17), respectively, and in the West for coccidioidomycosis with 13/100,000 (95% CI: 2, 23). The median age of all cases was 12 years (IQR: 7, 14). The presence of chronic comorbidities was negligible in the blastomycosis group. Eleven percent of children with histoplasmosis and 25% with coccidioidomycosis had a neoplasm, and 4-5% of both groups had a hematological or immunological deficiency. Deaths occurred among 4% of children with coccidioidomycosis. Conclusions: This nationally representative report of pediatric endemic fungal infections highlights the regional impact of these infections on children, who often do not have immunological deficiencies or underlying illnesses.

Learning Objectives: At the conclusion of the session, the participant will be able to

Keywords: Infectious Diseases, Children's Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Infectious Disease Epidemiology: Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA