Candida and the paediatric lung.

Although systemic candidosis is common in hospitalised children, Candida involvement of lung parenchyma is rare and usually perceived only at autopsy. The purpose of this article was to review the evidence regarding lung involvement in Candida infections, with special attention to paediatric patients. Primary Candida pneumonia is rare and usually associated with aspiration of oropharyngeal contents. The majority of cases of Candida pneumonia are secondary to haematological dissemination of Candida organisms from a distant site, usually the gastrointestinal tract or the skin. The diagnosis of pulmonary candidosis is difficult because there is no specific clinical or radiological presentation. In addition, the presence of Candida in sputum or other respiratory specimens mostly represents contamination. A definitive diagnosis of Candida pneumonia requires histopathologic proof of lung invasion in association with inflammation. Children can also be affected by pulmonary allergic reactions caused by Candida species. Treatment of Candida pneumonia is essentially the same as for candidaemia. Preliminary evidence suggests that patients with severe asthma sensitised to Candida species may also benefit from antifungal drugs.