Chronic Disseminated Candidiasis in Children and the Role of Corticosteroids Therapy

Laila S. Al Yazidi*, Nagi Elsidig, Yasser Wali, Hanan Nazir

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Background: Little is known about chronic disseminated candidiasis (CDC) in children. This study was done to describe the epidemiology, risk factors and outcome of CDC in children managed at Sultan Qaboos University Hospital (SQUH), Oman, and to describe the role of corticosteroids in the management of immune reconstitution inflammatory syndrome (IRIS) complicating CDC. Methods: We retrospectively reported demographic, clinical and laboratory data of all children managed in our center for CDC between January 2013 and December 2021. In addition, we discuss the available literature on the role of corticosteroids for management of CDC-related IRIS in children since 2005. Results: Between January 2013 and December 2021, 36 immunocompromised children were diagnosed with invasive fungal infection at our center, of whom 6 had CDC (all with acute leukemia). Their median age was 5.75 years. Prolonged fever despite broad-spectrum antibiotics (6/6) followed by skin rash (4/6) were the most common clinical features of CDC. Four children grew Candida tropicalis from blood or skin. CDC-related IRIS was documented in 5 children (83%) and 2 received corticosteroids. Our literature review revealed that 28 children were managed with corticosteroids for CDC-related IRIS since 2005. The majority of these children had defervescence of fever within 48 hours. Prednisolone of 1-2 mg/kg/day for 2-6 weeks was the most common regimen used. No major side effects reported in these patients. Conclusion: CDC is more common in children with acute leukemia and CDC-related IRIS is not uncommon. Corticosteroid therapy looks effective and safe as adjunctive therapy for CDC-related IRIS.

Original languageEnglish
Pages (from-to)E146-E151
JournalPediatric Infectious Disease Journal
Issue number5
Publication statusPublished - Feb 16 2023


  • children
  • chronic disseminated candidiasis
  • corticosteroids
  • immune reconstitution inflammatory syndrome
  • leukemia
  • Acute Disease
  • Adrenal Cortex Hormones/adverse effects
  • Humans
  • Child, Preschool
  • Candidiasis/drug therapy
  • Retrospective Studies
  • Antifungal Agents/therapeutic use
  • Child
  • Chronic Disease
  • Fever/microbiology
  • Leukemia, Myeloid, Acute/complications

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pediatrics, Perinatology, and Child Health

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