Clinical Challenges in Pediatric Transplant Infectious Diseases

Pediatric patients undergoing either hematopoietic stem cell transplant (HCT) or solid organ transplant (SOT) are at high risk of infectious complications due to their net state of immunosuppresion. The etiology of infections in these patients is associated to new exposures, reactivation of prior infections, or donor derived pathogens. The clinical presentation and severity of disease are frequently different from that of immunocompetent children, often leading to diagnostic and treatment challenges. Ample data exists on the clinical management of infections in the transplant adult population, but less has been reported on the diagnostic and clinical dilemmas faced by infectious diseases (ID) specialist who work with pediatric transplant recipients. We propose a Research Topic that will address these challenges through case reports and small case series, focusing on clinical syndromes and their management, including diagnostic and treatment modalities.

This Research Topic will address diagnostic and therapeutic challenges associated with infections in pediatric HCT and SOT recipients. Publications on these topics are scarce and are usually focused on rare pathogens or unusual presentations. We are proposing addressing these challenges in a more holistic manner by using a syndromic approach to addressing some of the clinical scenarios that an ID specialist faces on a daily practice and . Some examples include fever of unknown origin (FUO), approach to pulmonary nodules, central nervous system (CNS) infections, viral reactivations, gastrointestinal symptoms, and donor derived infections. We will invite experts the field of pediatric transplant ID to participate in this research topic in order to provide not only an overview of current literature and guidelines, but also expert opinion and clinical expertise.

We welcome authors to submit Case Reports on the following themes to help illustrate a specific syndrome, diagnostic or therapeutic challenge in pediatric transplant patients:

Fever of Unknown Origin
Lower respiratory tract/ Airspace disease
Pulmonary nodules
Diarrhea
Central nervous system (CNS) manifestations
Respiratory detection pretransplant
Skin/soft tissue infections
Multi drug resistant organisms MDRO
Donor derived infections
Pulmonary/CNS syndromes
Viral reactivation (herpesvirus)
Adenovirus in Pediatric HCT/SOT
Bone, joint and prosthetic limb infection
Approach to the global transplant candidate
Vector borne infections in transplant patients
Sexually transmitted infections
High risk donors (HIV, HBV, HCV)
Zoonotic infections-
Approach eosinophilia in transplant
Cardiovascular infections: pericarditis, endocarditis
Implanted mechanical device infections
Ocular /retinal infections