Objective: To explore the clinical characteristics of invasive pulmonary fungal infections (IPFI) in children

in order to improve the understanding of the disease and provide the basis for effective prevention and treatment of IPFI. Methods: A retrospective analysis was conducted on the clinical features

treatment

and outcomes of 89 children with IPFI

who were diagnosed

clinically diagnosed

and presumed to be diagnosed from January 2015 to June 2020 in our hospital. Results: Among the 89 cases of children with IPFI

57 were male

and 32 were female

with the median age of 6. 5 years. Among all the children

79 had underlying diseases

mainly hematologic malignancies. The host factors of the 10 patients without underlying disease were a history of severe adenovirus infection

antibiotic use for more than 10 days before diagnosis

and invasive procedures during hospitalization. The main clinical manifestations were high fever

cough

and sputum. The common chest CT findings were as follows: pneumonia-like manifestations in 75 cases (84. 3%)

nodular shadow in 34 cases (38. 2%)

and air bronchial sign in 29 cases (32. 6%). All children had antifungal therapy

with effective treatment rate of 86. 5%

and voriconazole was the main choice of antifungal drugs. Among all the children

73 patients had recurrent fever

and the temperature of 64 patients (87. 7%) stabilized after the addition of antifungal drugs. Before antifungal therapy in children with neutrophils to lack of time and corresponding hospital antifungal treatment time were positively correlated (r =0. 519

P<0. 01). Conclusion: Children with underlying diseases are the most favorite population for IPFI

while longterm use of antibiotics

severe infection and receiving invasive procedures are the main risk factors for children without underlying diseases. The diagnostic rate of IPFI in children is relatively low. For children at high risk with recurrent fever and agranulocytosis

it is necessary to be alert to fungal infection

conduct relevant laboratory and imaging examinations as early as possible

and make early diagnosis to improve the effect of antifungal therapy and reduce the length of hospital stay.