The following is a summary of “Prevalence, Predictive Factors, and Clinical Manifestations of Fungal Esophagitis in Children,” published in the November 2023 issue of Pediatrics by Correia, et al.

For a study, researchers sought to investigate the prevalence, symptoms, endoscopic characteristics, and predictive factors of fungal esophagitis (FE) in children, irrespective of their immune status. Focusing on understanding FE in children without human immunodeficiency virus, the objectives were to determine the frequency of FE, identify associated symptoms, explore endoscopic appearances, and ascertain predictive factors contributing to FE development.

Conducted as a retrospective case-control study from 2010 to 2020, the research involved 1,823 children undergoing elective endoscopy with esophageal biopsy at Sydney Children’s Hospital. Histopathology reports were scrutinized to detect FE cases and establish prevalence rates. Thirty-two FE patients were matched (1:2) by age and sex to 64 controls. Symptomatic patterns and potential risk factors for FE were analyzed using univariate and multivariate logistic regression.

The prevalence of FE in children was determined to be 1.76%. Noteworthy symptoms associated with FE included dysphagia (25%), heartburn (25%), poor oral intake (21.9%), vomiting (18.8%), cough (15.6%), nausea (12.5%), and weight loss (9.4%). Although white plaques were linked to FE during endoscopy (P < 0.001), visually normal findings were reported in 28.1% of FE cases. Topical swallowed corticosteroids emerged as a significant independent risk factor for FE (adjusted odds ratio = 10.740, 95% CI: 1.213–95.101, P = 0.033).

The FE prevalence in the pediatric cohort mirrored the rates observed in immunocompetent adults. As a considerable number of children presented with diverse gastrointestinal symptoms, the study underscored the necessity of esophageal biopsy for accurate FE diagnosis. Pediatricians should be mindful of the risk of FE when prescribing topical swallowed corticosteroids, emphasizing the importance of considering such factors in clinical decision-making.

Source: journals.lww.com/jpgn/abstract/2023/11000/prevalence,_predictive_factors,_and_clinical.9.aspx