{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T06:29:13Z","timestamp":1757312953353,"version":"3.37.3"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T00:00:00Z","timestamp":1701648000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T00:00:00Z","timestamp":1701648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100009473","name":"Universidad de M\u00e1laga","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009473","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The objective of this study is to provide practical recommendations on the management of pediatric patients with immune-mediated rheumatic diseases receiving immunosuppressive therapies. The recommendations specifically address the cases of surgery, fever, and opportunistic infections (varicella, herpes-zoster, tuberculosis, invasive fungal disease). A qualitative approach was applied. A narrative literature review was performed via Medline. Primary searches were conducted using MeSH terms and free text to identify publications on infections and vaccinations in pediatric patients with immune-mediated rheumatic diseases receiving immunosuppressive therapies. The results were presented and discussed in a nominal group meeting, comprising a committee of 12 pediatric rheumatologists from the Infection Prevention and Treatment Working Group of the Spanish Society of Pediatric Rheumatology. Several recommendations were generated. A consensus procedure was implemented via a Delphi process; this was extended to members of the Spanish Society of Pediatric Rheumatology and Spanish Society of Pediatric Infectious Disease of the Spanish Association of Pediatrics. Participants produced a score ranging from 0 (totally disagree) to 10 (totally agree). Agreement was defined as a vote\u2009\u2265\u20097 by at least 70% of participants. The literature review included more than 400 articles. Overall, 63 recommendations (19 on surgery, fever, and opportunistic infections) were generated and voted by 59 pediatric rheumatologists and other pediatric specialists. Agreement was reached for all 63 recommendations. The recommendations on special situations cover management in cases of surgery, fever, and opportunistic infections (varicella, herpes-zoster, tuberculosis, and invasive fungal disease).<\/jats:p><jats:p><jats:italic>\u00a0 Conclusions<\/jats:italic>: Hereby, we provided consensus and updated of recommendations about the management of special situations such as surgery, fever, and opportunistic in children with immune-mediated rheumatic diseases receiving immunosuppressive therapies. Several of the recommendations depend largely on clinical judgement and specific balance between risk and benefit for each individual and situation. To assess this risk, the clinician should have knowledge of the drugs, the patient\u2019s previous situation as well as the current infectious disease, in addition to experience.\n<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is Known:<\/jats:bold><jats:italic>\u2022 Infectious diseases and related complications are a major cause of morbidity and mortality in patients with immune-mediated rheumatic diseases.<\/jats:italic><jats:italic>\u2022 Information on how to manage the treatment in situations of fever, opportunistic infections, and surgery in children is limited, and guidelines for action are often extrapolated from adults.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is New:<\/jats:bold><jats:italic>\u2022 In the absence of strong evidence, a literature review and a Delphi survey were conducted to establish a series of expert recommendations that could support the clinical practice, providing a practical and simple day-to-day approach to be used by pediatric rheumatologists.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-023-05295-4","type":"journal-article","created":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T12:02:28Z","timestamp":1701691348000},"page":"915-927","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Position statement on infection screening, prophylaxis, and vaccination of pediatric patients with rheumatic diseases and immunosuppressive therapies, part 3: precautions in situations of surgery, fever, and opportunistic infections"],"prefix":"10.1007","volume":"183","author":[{"given":"Daniel","family":"Clemente","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esmeralda N\u00fa\u00f1ez","family":"Cuadros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisol Camacho","family":"Lovillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan Calzada","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara Guill\u00e9n","family":"Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Fern\u00e1ndez","family":"Silveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9 Lirola","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Tagarro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa Mar\u00eda Alcobendas","family":"Rueda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agust\u00edn","family":"L\u00f3pez L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miren Satrustegi","family":"Aritziturri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Calvo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,12,4]]},"reference":[{"key":"5295_CR1","doi-asserted-by":"crossref","unstructured":"Furer V, Rondaan C, Heijstek M, van Assen S, Bijl M, Agmon-Levin N et al (2019) Incidence and prevalence of vaccine preventable infections in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD): a systemic literature review informing the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD. RMD Open 5(2)","DOI":"10.1136\/rmdopen-2019-001041"},{"key":"5295_CR2","doi-asserted-by":"crossref","unstructured":"Heijstek MW, Ott De Bruin LM, Bijl M, Borrow R, van der Klis F, Kon\u00e9-Paut I et al (2011) EULAR recommendations for vaccination in paediatric patients with rheumatic diseases. Ann Rheum Dis 70(10):1704\u201312","DOI":"10.1136\/ard.2011.150193"},{"issue":"4","key":"5295_CR3","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1007\/s00296-020-04774-3","volume":"41","author":"F Thiele","year":"2021","unstructured":"Thiele F, Klein A, Windschall D, Hospach A, Foeldvari I, Minden K et al (2021) Comparative risk of infections among real-world users of biologics for juvenile idiopathic arthritis: data from the German BIKER registry. Rheumatol Int 41(4):751\u2013762","journal-title":"Rheumatol Int"},{"issue":"6","key":"5295_CR4","doi-asserted-by":"publisher","first-page":"2343","DOI":"10.1007\/s00431-022-04418-7","volume":"181","author":"E Cuadros","year":"2022","unstructured":"Cuadros E, Calzada-Hern\u00e1ndez J, Clemente D, Mart\u00edn S, Silveira L, Lirola-Cruz M et al (2022) Position statement of the Spanish Society of Pediatric Rheumatology on infection screening, prophylaxis, and vaccination of pediatric patients with rheumatic diseases and immunosuppressive therapies: part 1 (screening). Eur J Pediatr 181(6):2343\u20132354","journal-title":"Eur J Pediatr"},{"key":"5295_CR5","unstructured":"CEBM Medicine (2011) CfEB: CEBM levels of evidence 2011. http:\/\/www.cebm.net\/index.aspx?o=1025. Accessed 4 Nov 2013"},{"issue":"8","key":"5295_CR6","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1002\/acr.23274","volume":"69","author":"SM Goodman","year":"2017","unstructured":"Goodman SM, Springer B, Guyatt G, Abdel MP, Dasa V, George M et al (2017) American college of rheumatology\/american association of hip and knee surgeons guideline for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty. Arthritis Care Res (Hoboken) 69(8):1111\u20131124","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"5295_CR7","doi-asserted-by":"crossref","unstructured":"Zakaryan A, Ginosyan K (2020) Perioperative management of patients with ankylosing spondylitis undergoing spine surgery. Front Pharmacol 11(1017)","DOI":"10.3389\/fphar.2020.01017"},{"issue":"4","key":"5295_CR8","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1093\/pch\/pxab015","volume":"26","author":"A Ahmet","year":"2021","unstructured":"Ahmet A, Rowan-Legg A, Pancer L (2021) Adrenal suppression from exogenous glucocorticoids: recognizing risk factors and preventing morbidity. Paediatr Child Health 26(4):242\u2013247","journal-title":"Paediatr Child Health"},{"key":"5295_CR9","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1542\/peds.2006-1612","volume":"119","author":"DI Shulman","year":"2007","unstructured":"Shulman DI, Palmert MR, Kemp SF (2007) Adrenal insufficiency: still a cause of morbidity and death in childhood. Pediatrics 119:484\u2013494","journal-title":"Pediatrics"},{"key":"5295_CR10","unstructured":"Amir H Hamrahian (2023) The management of the surgical patient taking glucocorticoids. Uptodate. Last updated: March, 2023"},{"issue":"6","key":"5295_CR11","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1016\/j.jbspin.2015.10.019","volume":"83","author":"M Clay","year":"2016","unstructured":"Clay M, Mazouyes A, Gilson M, Gaudin P, Baillet A (2016) Risk of postoperative infections and the discontinuation of TNF inhibitors in patients with rheumatoid arthritis: a meta-analysis. Joint Bone Spine 83(6):701\u2013705","journal-title":"Joint Bone Spine"},{"key":"5295_CR12","doi-asserted-by":"publisher","first-page":"253","DOI":"10.3349\/ymj.2013.54.1.253","volume":"54","author":"H Pieringer","year":"2013","unstructured":"Pieringer H, Danninger K, Tzaribachev N, B\u00f6hler N, Pohanka E, Herold M (2013) Patients with arthritis undergoing surgery: how should we manage tumour necrosis factor blocking agents perioperatively? -a systematic literature review. Yonsei Medical J 54:253\u2013257","journal-title":"Yonsei Medical J"},{"issue":"12","key":"5295_CR13","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1002\/acr.22077","volume":"65","author":"CB Scherrer","year":"2013","unstructured":"Scherrer CB, Mannion AF, Kyburz D, Vogt M, Kramers-De Quervain IA (2013) Infection risk after orthopedic surgery in patients with inflammatory rheumatic diseases treated with immunosuppressive drugs. Arthritis Care Res 65(12):2032\u20132040","journal-title":"Arthritis Care Res"},{"issue":"1","key":"5295_CR14","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1186\/s12969-021-00626-x","volume":"19","author":"J Molimard","year":"2021","unstructured":"Molimard J, Pajot C, Olle P, Belot A, Quartier P, Uettwiller F et al (2021) Immunomodulatory treatment and surgical management of idiopathic uveitis and juvenile idiopathic arthritis-associated uveitis in children: a French survey practice. Pediatr Rheumatol Online J 19(1):139","journal-title":"Pediatr Rheumatol Online J"},{"issue":"10","key":"5295_CR15","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.917731","volume":"11","author":"C Udaondo","year":"2022","unstructured":"Udaondo C, N\u00fa\u00f1ez Cuadros E, Murias S, Remesal A, Alcobendas R, Guerrero C et al (2022) Are infections in children with juvenile idiopathic arthritis more frequent than in healthy children? A prospective multicenter observational study. Front Pediatr 11(10):917731","journal-title":"Front Pediatr"},{"key":"5295_CR16","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/s11926-015-0542-z","volume":"17","author":"G Horneff","year":"2015","unstructured":"Horneff G (2015) Biologic-associated infections in pediatric rheumatology. Curr Rheumatol Rep 17:66","journal-title":"Curr Rheumatol Rep"},{"issue":"8","key":"5295_CR17","doi-asserted-by":"publisher","first-page":"2773","DOI":"10.1002\/art.34458","volume":"64","author":"T Beukelman","year":"2012","unstructured":"Beukelman T, Xie F, Chen L, Baddley JW, Delzell E, Grijalva CG et al (2012) Rates of hospitalized bacterial infection associated with juvenile idiopathic arthritis and its treatment. Arthritis Rheum 64(8):2773\u20132780","journal-title":"Arthritis Rheum"},{"issue":"2","key":"5295_CR18","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1080\/14397595.2017.1349059","volume":"28","author":"JB Brunelli","year":"2018","unstructured":"Brunelli JB, Schmidt AR, Sallum AME, Goldenstein-Schainberg C, Bonf\u00e1 E, Silva CA et al (2018) High rate of serious infection in juvenile idiopathic arthritis patients under biologic therapy in a real-life setting. Mod Rheumatol 28(2):264\u2013270","journal-title":"Mod Rheumatol"},{"key":"5295_CR19","doi-asserted-by":"crossref","unstructured":"Nagy A, M\u00e1trai P, Hegyi P, Alizadeh H, Bajor J, Czopf L et al (2019) The effects of TNF-alpha inhibitor therapy on the incidence of infection in JIA children: a meta-analysis. Pediatr Rheumatol Online J 17(1):4","DOI":"10.1186\/s12969-019-0305-x"},{"issue":"4","key":"5295_CR20","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1093\/rheumatology\/kex189","volume":"57","author":"M Cates","year":"2018","unstructured":"Cates M, Donati M, Gillet S, Ustianowski A, Galloway J (2018) Managing varicella zoster virus contact and infection in patients on anti-rheumatic therapy. Rheumatology (Oxford) 57(4):596\u2013605","journal-title":"Rheumatology (Oxford)"},{"issue":"4","key":"5295_CR21","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1093\/rheumatology\/kex519","volume":"57","author":"M Cates","year":"2018","unstructured":"Cates M, Donati M, Gillet S, Ustianowski A, Galloway J (2018) Comment on: managing varicella zoster virus contact and infection in patients on anti-rheumatic therapy. Rheumatology (Oxford) 57(4):768","journal-title":"Rheumatology (Oxford)"},{"key":"5295_CR22","unstructured":"Public Health England (2019) Updated guidelines on post exposure prophylaxis (PEP) for varicella\/shingles June 2019. https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/812526\/PHE_PEP_VZIG_guidance_for_health_professionals.pdf"},{"key":"5295_CR23","doi-asserted-by":"crossref","unstructured":"Committee on Infectious Diseases. American Academy of Pediatrics; Kimberlin DW, Brady MT, Jackson MA, Long SS. Varicella-Zoster virus infections. In: Red Book 2018. 31st Edition 869\u2013883","DOI":"10.1542\/9781610021470-part03-varicella_zoster"},{"issue":"11","key":"5295_CR24","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1097\/00006454-199711000-00021","volume":"16","author":"CG Prober","year":"1997","unstructured":"Prober CG (1997) Acyclovir therapy in a steroid recipient with varicella. Pediatr Infect Dis J 16(11):1095\u20131096","journal-title":"Pediatr Infect Dis J"},{"issue":"2","key":"5295_CR25","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1093\/clinids\/22.2.341","volume":"22","author":"MJ Wood","year":"1996","unstructured":"Wood MJ, Kay R, Dworkin RH, Soong SJ, Whitley RJ (1996) Oral acyclovir therapy accelerates pain resolution in patients with herpes zoster: a meta-analysis of placebo-controlled trials. Clin Infect Dis 22(2):341\u2013347","journal-title":"Clin Infect Dis"},{"issue":"7","key":"5295_CR26","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1128\/AAC.39.7.1546","volume":"39","author":"K Beutner","year":"1995","unstructured":"Beutner K, Friedman D, Forszpaniak C, Andersen P, Wood M (1995) Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults. Antimicrob Agents Chemother 39(7):1546\u20131553","journal-title":"Antimicrob Agents Chemother"},{"issue":"1","key":"5295_CR27","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12969-016-0095-3","volume":"14","author":"R Leuvenink","year":"2016","unstructured":"Leuvenink R, Aeschlimann F, Baer W, Berthet G, Cannizzaro E, Hofer M et al (2016) Clinical course, and therapeutic approach to varicella zoster virus infection in children with rheumatic autoimmune diseases under immunosuppression. Pediatr Rheumatol Online J 14(1):34","journal-title":"Pediatr Rheumatol Online J"},{"key":"5295_CR28","doi-asserted-by":"crossref","unstructured":"Moreno-P\u00e9rez D, Andr\u00e9s Mart\u00edn A, Altet G\u00f3mez N, Baquero-Artigao F, Escribano Montaner A, G\u00f3mez-Pa\u00edstrana Dur\u00e1n D et al (2010) Diagnosis of tuberculosis in paediatrics. An Pediatr (Barc) 72(4):283.e1\u2013283.e14","DOI":"10.1016\/j.anpedi.2010.01.002"},{"key":"5295_CR29","doi-asserted-by":"crossref","unstructured":"Silva DR, Rabahi MF, Sant\u2019Anna CC, da Silva-Junior JLR, Capone D, Bombarda S et al (2021) Diagnosis of tuberculosis: a consensus statement from the Brazilian Thoracic Association. J Brasil Pneumol 47(2):e20210054","DOI":"10.36416\/1806-3756\/e20210054"},{"key":"5295_CR30","doi-asserted-by":"crossref","unstructured":"Pillay T, Andronikou S, Zar HJ (2020) Chest imaging in paediatric pulmonary TB. Vol. 36, Paediatr Respir Rev 36:65\u201372","DOI":"10.1016\/j.prrv.2020.10.002"},{"issue":"2","key":"5295_CR31","doi-asserted-by":"publisher","first-page":"161","DOI":"10.3390\/pathogens11020161","volume":"11","author":"M Nel","year":"2022","unstructured":"Nel M, Franckling-Smith Z, Pillay T, Andronikou S, Zar HJ (2022) Chest imaging for pulmonary TB\u2014an update. Pathogens 11(2):161","journal-title":"Pathogens"},{"issue":"3","key":"5295_CR32","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1136\/adc.2007.136929","volume":"94","author":"M Hatherill","year":"2009","unstructured":"Hatherill M, Hawkridge T, Zar HJ, Whitelaw A, Tameris M, Workman L et al (2009) Induced sputum, or gastric lavage for community-based diagnosis of childhood pulmonary tuberculosis? Arch Dis Child 94(3):195\u2013201","journal-title":"Arch Dis Child"},{"key":"5295_CR33","first-page":"52","volume":"36","author":"MP Nicol","year":"2020","unstructured":"Nicol MP, Zar HJ (2020) Advances in the diagnosis of pulmonary tuberculosis in children. Paediatr Respir Rev 36:52\u201356","journal-title":"Paediatr Respir Rev"},{"key":"5295_CR34","doi-asserted-by":"crossref","unstructured":"Mellado Pe\u00f1a MJ, Santiago Garc\u00eda B, Baquero-Artigao F, Moreno P\u00e9rez D, Pi\u00f1eiro P\u00e9rez R, M\u00e9ndez Echevarr\u00eda A et al (2018) Tuberculosis treatment for children: an update. An Pediatr (Barc) 88(1):52.e1\u201352.e12","DOI":"10.1016\/j.anpede.2017.05.001"},{"key":"5295_CR35","doi-asserted-by":"crossref","unstructured":"Cantini F, Nannini C, Niccoli L, Iannone F, Delogu G, Garlaschi G et al (2015) Guidance for the management of patients with latent tuberculosis infection requiring biologic therapy in rheumatology and dermatology clinical practice. Autoimmun Rev 14:503\u20139","DOI":"10.1016\/j.autrev.2015.01.011"},{"key":"5295_CR36","doi-asserted-by":"crossref","unstructured":"Calzada-Hern\u00e1ndez J, Anton-L\u00f3pez J, Bou-Torrent R, Iglesias-Jim\u00e9nez E, Ricart-Campos S, Mart\u00edn de Carpi J et al (2015) Tuberculosis in pediatric patients treated with anti-TNF\u03b1 drugs: a cohort study. Pediatr Rheumatol Online J 13(54)","DOI":"10.1186\/s12969-015-0054-4"},{"issue":"10","key":"5295_CR37","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1056\/NEJMoa2104535","volume":"386","author":"A Turkova","year":"2022","unstructured":"Turkova A, Wills GH, Wobudeya E, Chabala C, Palmer M, Kinikar A et al (2022) Shorter treatment for nonsevere tuberculosis in African and Indian children. N Engl J Med 386(10):911\u2013922","journal-title":"N Engl J Med"},{"key":"5295_CR38","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.1093\/cid\/cit489","volume":"57","author":"SS Toussi","year":"2013","unstructured":"Toussi SS, Pan N, Walters HM, Walsh T (2013) Infections in children and adolescents with juvenile idiopathic arthritis and inflammatory bowel disease treated with tumor necrosis factor-Inhibitors: systematic review of the literature. Clin Infect Dis 57:1318\u20131330","journal-title":"Clin Infect Dis"},{"key":"5295_CR39","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1080\/17476348.2021.1828069","volume":"15","author":"JA Seddon","year":"2021","unstructured":"Seddon JA, Johnson S, Palmer M, van der Zalm MM, Lopez-Varela E, Hughes J et al (2021) Multidrug-resistant tuberculosis in children and adolescents: current strategies for prevention and treatment. Expert Rev Respir Med 15:221\u2013237","journal-title":"Expert Rev Respir Med"},{"key":"5295_CR40","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1093\/jpids\/pix046","volume":"6","author":"ZD Pana","year":"2017","unstructured":"Pana ZD, Roilides E, Warris A, Groll AH, Zaoutis T (2017) Epidemiology of invasive fungal disease in children. J Pediatric Infect Dis Soc 6:S3\u201311","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"Suppl 1","key":"5295_CR41","first-page":"59","volume":"29","author":"JT Ramos","year":"2016","unstructured":"Ramos JT, Francisco L, Daoud Z (2016) Invasive fungal infections in children: similarities and differences with adults. Rev Esp Quimioter 29(Suppl 1):59\u201365","journal-title":"Rev Esp Quimioter"},{"issue":"6","key":"5295_CR42","first-page":"1018","volume":"35","author":"M Galli","year":"2017","unstructured":"Galli M, Antinori S, Atzeni F, Meroni L, Riva A, Scir\u00e8 C et al (2017) Recommendations for the management of pulmonary fungal infections in patients with rheumatoid arthritis. Clin Exp Rhumatol 35(6):1018\u20131028","journal-title":"Clin Exp Rhumatol"},{"issue":"9","key":"5295_CR43","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1177\/0961203313496342","volume":"22","author":"JP Vinicki","year":"2013","unstructured":"Vinicki JP, Pellet SC, Pappalardo C, Cruzat VC, Spinetto MA, Dubinsky D et al (2013) Invasive fungal infections in Argentine patients with systemic lupus erythematosus. Lupus 22(9):892\u2013898","journal-title":"Lupus"},{"issue":"7","key":"5295_CR44","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1177\/0961203309103081","volume":"18","author":"HJ Kim","year":"2009","unstructured":"Kim HJ, Park YJ, Kim WU, Park SH, Cho CS (2009) Invasive fungal infections in patients with systemic lupus erythematosus: experience from affiliated hospitals of Catholic University of Korea. Lupus 18(7):661\u2013666","journal-title":"Lupus"},{"key":"5295_CR45","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1111\/myc.12576","volume":"60","author":"A Tragiannidis","year":"2017","unstructured":"Tragiannidis A, Kyriakidis I, Z\u00fcndorf I, Groll AH (2017) Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF-\u03b1) inhibitors. Mycoses 60:222\u2013229","journal-title":"Mycoses"},{"key":"5295_CR46","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/myc.12621","volume":"60","author":"I Kyriakidis","year":"2017","unstructured":"Kyriakidis I, Tragiannidis A, Z\u00fcndorf I, Groll AH (2017) Invasive fungal infections in paediatric patients treated with macromolecular immunomodulators other than tumour necrosis alpha inhibitors. Mycoses 60:493\u2013507","journal-title":"Mycoses"},{"issue":"3","key":"5295_CR47","doi-asserted-by":"publisher","first-page":"E69","DOI":"10.1097\/INF.0000000000003402","volume":"41","author":"L Ferreras-Antol\u00edn","year":"2022","unstructured":"Ferreras-Antol\u00edn L, Irwin A, Atra A, Chapelle F, Drysdale SB, Emonts M et al (2022) Pediatric antifungal prescribing patterns identify significant opportunities to rationalize antifungal use in children. Pediatr Infect Dis J 41(3):E69\u201374","journal-title":"Pediatr Infect Dis J"},{"key":"5295_CR48","doi-asserted-by":"crossref","unstructured":"Ferreras-Antol\u00edn L, Sharland M, Warris A (2019) Management of invasive fungal disease in neonates and children. Pediatr Infect Dis J 38(6 S Suppl 1):S2\u20136","DOI":"10.1097\/INF.0000000000002317"},{"key":"5295_CR49","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.anpedi.2020.04.031","volume":"95","author":"L Mart\u00edn Pedraz","year":"2021","unstructured":"Mart\u00edn Pedraz L, Carazo Gallego B, Moreno PD (2021) Clinical-epidemiological characteristics of Pneumocystis jirovecii pneumonia in a tertiary hospital in Spain. An Pediatr (Barc) 95:4\u201310","journal-title":"An Pediatr (Barc)"},{"issue":"9","key":"5295_CR50","doi-asserted-by":"publisher","first-page":"2405","DOI":"10.1093\/jac\/dkw158","volume":"71","author":"G Maschmeyer","year":"2016","unstructured":"Maschmeyer G, Helweg-Larsen J, Pagano L, Robin C, Cordonnier C, Schellongowski P et al (2016) ECIL guidelines for treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients. J Antimicrob Chemother 71(9):2405\u20132413","journal-title":"J Antimicrob Chemother"},{"key":"5295_CR51","unstructured":"Thomas CF, Limper AH (2023) Treatment and prevention of Pneumocystis pneumonia in patients without HIV. Uptodate. Last Updated: October 2023"},{"issue":"4","key":"5295_CR52","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1186\/ar3893","volume":"14","author":"AR Huppler","year":"2012","unstructured":"Huppler AR, Bishu S, Gaffen SL (2012) Mucocutaneous candidiasis: the IL-17 pathway and implications for targeted immunotherapy. Arthritis Res Ther 14(4):217","journal-title":"Arthritis Res Ther"},{"key":"5295_CR53","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/bjd.15015","volume":"177","author":"DM Saunte","year":"2017","unstructured":"Saunte DM, Mrowietz U, Puig L, Zachariae C (2017) Candida infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 inhibitors and their practical management. Br J Dermatol 177:47\u201362","journal-title":"Br J Dermatol"},{"key":"5295_CR54","first-page":"545","volume":"156","author":"C Rodr\u00edguez-Cerdeira","year":"2021","unstructured":"Rodr\u00edguez-Cerdeira C, Gonz\u00e1lez-Cesp\u00f3n JL, Mart\u00ednez-Herrera E, Carnero-Gregorio M, L\u00f3pez-Barcenas A, Sergeev A et al (2021) Candida infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 inhibitors and their practical management. Ital J Dermatol Venerol 156:545\u2013557","journal-title":"Ital J Dermatol Venerol"},{"issue":"Suppl 1","key":"5295_CR55","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1136\/annrheumdis-2021-eular.5038","volume":"80","author":"N Ruperto","year":"2021","unstructured":"Ruperto N, Foeldvari I, Alexeeva E, Aktay Ayaz N, Calvo I, Kasapcopur O et al (2021) Efficacy and safety of secukinumab in enthesitis-related arthritis and juvenile psoriatic arthritis: primary results from a randomised, double-blind, placebo-controlled, treatment withdrawal, phase 3 study (JUNIPERA). Ann Rheum Dis 80(Suppl 1):201\u2013202","journal-title":"Ann Rheum Dis"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-023-05295-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-023-05295-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-023-05295-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T12:14:02Z","timestamp":1709554442000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-023-05295-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,4]]},"references-count":55,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["5295"],"URL":"https:\/\/doi.org\/10.1007\/s00431-023-05295-4","relation":{},"ISSN":["1432-1076"],"issn-type":[{"type":"electronic","value":"1432-1076"}],"subject":[],"published":{"date-parts":[[2023,12,4]]},"assertion":[{"value":"18 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2023","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 October 2023","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 December 2023","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}