Who can enter
- Children with a suspected fungal infection in the lungs
- Children 0-18 years
Goal
The purpose of this study is to learn what fungal infections of the lungs look like on CT scans and how these scans change during treatment with antifungal medication.
In this study, we will take an additional CT scan of the lungs of children/teenagers who are likely to have a fungal infection in their lungs. By comparing all the CT scans of the child's lungs and the lungs of other children in the study, we hope to better understand how a fungal infection changes over the course of a fungal treatment, and thereby improve this treatment in the future.
In addition, we want to preserve blood and fluid from a lung wash to improve other tests used to detect fungal infections.
Background
CT scans and other tests are already routinely used to see if there are signs of a fungal infection of the lungs, when a child has unexplained fever or respiratory symptoms. If there is evidence of this, one or more antifungal drugs are started and the CT scan is repeated after 14 days to see its effect. Depending on this second CT scan, the therapy is then often adjusted. In case of a good result, often only one antifungal agent is continued. In the absence of a good treatment result, one drug will be added to the therapy or a stronger drug will be chosen.
We want to investigate whether the information from an additional CT scan 7 days after the first scan can provide a faster adjustment of treatment. Studies in adults have shown that a scan on day 7 provides additional information about the course of the fungal infection that may be important for treatment decisions.
In standard diagnostics, in addition to a CT scan, a flush of the lungs is performed (BAL) at the time of a suspected fungal infection. Blood is also taken regularly for testing. The tests done on the lung flush and on the blood cannot always determine with certainty whether there is a fungal infection or, on the contrary, rule out the possibility that there is no longer a fungal infection.
We want to do additional tests on the blood and fluid collected from the lung flush and combine it with the information from the CT scans. Additional blood will be drawn during standard blood collection. The lung flush is already done according to standard treatment, only the residue will be kept. We hope to use this to improve diagnostic tests. The goal is to in the future detect or rule out fungal infection with greater certainty.