Program Description

This interactive, enduring, multimedia activity is based on the second component of the ICAAC 2013 satellite symposium, Invasive Mycoses: Consider the Source, Consider the Host. In Pediatric Mycoses: Same But Different, Theoklis Zaoutis, MD, MSCE, discusses cases illustrating the state-of-the-art management of invasive fungal infections (IFIs) in children. Highlighting important issues for the prevention and management of invasive candidiasis and invasive mold infections in oncology and ICU settings, Dr Zaoutis also reviews the levels of evidence behind different diagnostic tests in children, drug dosing strategies, as well as the role of therapeutic dose monitoring. The activity will also include bonus material about current and emerging antifungal therapy and diagnostic options (developed by Peter G. Pappas, MD, FACP). 


CME Information

Title: Pediatric Mycoses: Same But Different


RELEASE DATE: 02/14/2014


MEDIA: Interactive presentation


Statement of Need


Invasive fungal infections (IFIs) remain a substantial source of morbidity and mortality. While the increasing burden of IFIs is generally seen as a byproduct of modern medicine and an increasing net state of immunosuppression, emerging data on genomics and the immunologic response of the host are informing a deeper understanding of what happens at the level of the patient. There are differences in IFIs among pediatric patients, solid organ transplant (SOT) patients, and hematopoietic stem cell transplant (HSCT) patients in terms of causative pathogens (the source), the host response to the pathogens, diagnostic considerations, and response to therapeutic interventions.

This activity will explore whether our increased understanding of these interrelated factors can lead to personalized therapy for IFIs, as is occurring in oncology. Against this backdrop, we have documented gaps in managing IFIs per evidence-based society guidelines, such as in initiating prophylactic, preemptive, and empiric therapy (when appropriate) and definitive treatment across these host types. Finally, as emerging diagnostics and therapeutics are developed, their efficacy in these varied host populations as well as their interactions with host factors are key considerations. This second activity in the series will discuss antifungal strategies specific to pediatric patients. 


Learning Objectives


After completing this activity, the participants will be better able to:

  • Define differences in IFI epidemiology and response to therapeutics in pediatric patients vs adults
  • Discuss strategies to optimize the dosages of antifungal agents for use in children
  • Choose appropriate therapy for at-risk patients as well as diagnostic and treatment approaches for pediatric intensive care unit and pediatric oncology patients with IFIs


Target Audience


This activity is directed to infectious disease physicians, hematologists/oncologists, critical care physicians, transplant physicians, pathologists, pediatricians, and other healthcare providers responsible for the management of invasive mycoses. 




The University of Nebraska Medical Center, Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. 

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of  the University of Nebraska Medical Center, Center for Continuing Education and Terranova Medica.

The University of Nebraska Medical Center, Center for Continuing Education designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  


Disclosure Declaration


As a provider accredited by ACCME, the University of Nebraska Medical Center, Center for Continuing Education must ensure balance, objectivity, independence, and scientific rigor in its educational activities. Faculty are encouraged to provide a balanced view of therapeutic options by utilizing either generic names or the trade names of several to ensure impartiality.

All speakers, planning committee members and others in a position to control continuing medical education content participating in a University of Nebraska Medical Center, Center for Continuing Education activity are required to disclose relationships with commercial interests. A commercial interest is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Disclosure of these commitments and/or relationships is included in these activity materials so that participants in the activity may formulate their own judgments in interpreting its content and evaluating its recommendations.

This activity may include presentations in which faculty may discuss off-label and/or investigational use of pharmaceuticals or instruments not yet FDA-approved. Participants should note that the use of products outside currently FDA-approved labeling should be considered experimental and are advised to consult current prescribing information for FDA-approved indications.

The following indicates the disclosure declaration information and the nature of those commercial relationships.

All materials are included with the permission of the authors. The opinions expressed are those of the authors and are not to be construed as those of the University of Nebraska Medical Center, Center for Continuing Education


Faculty Disclosures


Merck & Co.


Almost all antifungals are off-label in children.


Astellas Pharma US; Gilead; Merck & Co; Pfizer, Inc; T-2 Biosystems
Astellas; Gilead; Merck & Co; T-2 Biosystems
New therapeutics for invasive mycoses, including isavuconazole, ravuconazole, and posaconazole tablet formulation


Planning Committee Disclosures


No conflicts to disclose.

No conflicts to disclose.

No conflicts to disclose.

No conflicts to disclose.


Instructions for Participation


To receive a CME certificate of participation, participants should:

  • Follow instructions to register or log in with your professional information.
  • Complete the on-line activity, ensuring they answer all pre-test and polling questions.
  • Complete and submit the online posttest and evaluation. You must answer 70% of the posttest questions correctly to earn credit.
  • A certificate of participation will be available for download/printing immediately following your successful completion of the posttest and evaluation.


System Requirements


To participate, you will need access to a computer (either MAC or PC) with a Chrome (version 22.0.1229.94 or greater) web browser, Firefox (version 3.6 or greater) web browser or an Internet Explorer (version 8.0 or greater) web browser, Javascript enabled, connected to the Internet (high speed connection preferred). 


Privacy Policy


Privacy policy
Terranova Medica, LLC and UNMC CCE are committed to protecting the privacy of those who choose to participate in activities on This information below describes our security policies for safeguarding personal information as well as the rationale for collection and use of personal information.

Security/safeguarding personal information
This website has physical and procedural safeguards in place to prevent unauthorized access to personal information used to access this website.

Collection and use of personal information
To earn CME credits using the website, the UNMC CCE requires submission of certain personally identifiable information. The required items include: first name, last name, degree, and e-mail address. These items are necessary to award and track the credits that participants may earn after completing the program. To obtain credit, learners must complete an evaluation of the CME activity.  This information is used in a continuous improvement process to enhance the learning experience of future programs


Terranova Medica, LLC, and UNMC CCE do not transfer, sell, or share personal information with outside parties. We will not disclose the information unless required in a legal proceeding.

Release Date: February 14, 2014.




The opinions or views expressed in this continuing education activity are those of the faculty and do not necessarily reflect the opinions or recommendations of the University of Nebraska Medical Center, Center for Continuing Education; the Mycoses Study Group Education & Research Consortium; and Terranova Medica, LLC.

Healthcare professionals and other individuals should review and consider other publications and materials on the subject before relying solely upon the information contained within this educational activity.


Additional Information


There is no charge for this activity.

This activity is supported by independent educational grants from Astellas Scientific and Medical Affairs Inc.; Merck; Gilead Sciences Europe, Ltd; IMMY; Viracor-IBT; T2 Biosystems; and MiraVista Diagnostics.

This event is neither sponsored nor endorsed by the American Society for Microbiology.

For further information, contact Tom Davis by telephone 877-276-4523, fax 805-648-8070, or email (


Copyright 2014 UNMC CCE, Terranova Medica, LLC, and MSG-ERC.

Sponsored by The University of Nebraska Medical Center, TerraNova Medica, and The MSG Education & Research Consortium
This activity is supported by independent educational grants from Astellas Scientific and Medical Affairs Inc.; Merck; Gilead Sciences Europe, Ltd; IMMY; Viracor-IBT; T2 Biosystems; and MiraVista Diagnostics.

Photo of Mature sporangium of a Mucor sp. fungus provided by: CDC/Dr. Lucille K. Georg [Public domain], via Wikimedia Commons.