Background and Purpose: Invasive aspergillosis is commonly discussed in the setting of immunocompromised individuals. Not much has been stated about its occurrence in the immunocompetent, particularly in children. Thus, its cognizance in a non-immunocompromised child is pertinent as it may be considered an unlikely differential in such a setting, leading to preventable morbidities.
Materials and Methods: We conducted a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. All articles with primary data on Aspergillus infection in immunocompetent children were eligible for inclusion.
Results: We identified 34 cases of aspergillosis in non-immunocompromised children across the globe. Invasive aspergillosis (n=29, 85.3%) was the predominant clinical phenotype. Others were primary cutaneous aspergillosis (n=4, 11.8%), and non-invasive bronchial Aspergillus colonization (n=1, 2,9%). Risk factors were identified in only 13 (38.2%): trauma (n=1), surgeries (n=7), aspiration of foreign body (n=1), near drowning (n=1), congenital abnormalities (n=3), the use of arterial lines and adhesives (n=2). No known risk factors were associated with the other cases (n=21, 61.8%). Of the 34 cases, 29 (85.3%) recovered, 4 (11.8%) died and a cure was not achieved in one (2.9%).
Conclusion: Aspergillosis may present as an unexpected clinical entity in immunocompetent children, resulting in fatal outcomes, particularly when the diagnosis and or the initiation of appropriate therapy is delayed. In addition, the preponderance of the invasive forms affirms the need for a high index of suspicion of aspergillosis in children regardless of immune status. Therefore, the attending clinician's awareness of this clinical entity is crucial to ensure favourable outcomes.