Management of invasive fungal infections in the pediatric intensive care unit

Invasive candidiasis (IC) are the most common invasive fungal infections in pediatric intensive care unit patients due to commonly present risk factors including central venous catheters, antibiotic exposure, recent surgery, total parenteral nutrition, and prior colonization with Candida species. These infections are economically costly and have been associated with an attributable mortality of approximately 10%. As a result, investigators have attempted to identify cohorts of pediatric intensive care unit patients at highest risk of development of IC who may benefit from prophylactic, early empiric, or pre-emptive therapy. This review article will consider these prediction models and therapeutic approaches. Additionally, the management of confirmed IC, including anti-fungal therapeutic options, evaluation for disseminated disease, and management of central venous catheters, will be reviewed.