Invasive Rhino-Orbito-Cerebral Mucormycosis in Pediatric Patient with Acute Leukemia

Česká verzia

Authors: Eva Bačová ¹; Filip Chovanec ¹; Miroslava Makohusová ¹; Stanislava Hederová ¹; Martina Mikesková ¹; Andrea Hrašková ¹; Bruno Rudinský ²; Lukáš Plank ³; Pavlína Volfová ⁴; Alexandra Kolenová ¹
Authors place of work: Klinika detskej hematológie a onkológie LF UK a Národný ústav detských chorôb, Bratislava, Slovenská republika 2 Neurocentrum, Klinika detskej chirurgie LF UK a Národný ústav detských chorôb, Bratislava, Slovenská republika 3 Ústav patologickej anatómie, ¹
Published in the journal: Klin Onkol 2020; 33(2): 138-144
Category: Case Report
doi: https://doi.org/10.14735/amko2020138

Summary

Background: Invasive fungal infections are a life-threatening complication of cancer treatments, especially in hemato-oncological patients. Mucormycosis is the third leading cause of invasive fungal infections after Aspergillus and Candida infections. The first clinical symptoms are usually non-specific, which can lead to a late diagnosis and delayed therapy.

Purpose: The objective of this report is to summarize data in the literature about mucormycosis and to present a case report of a patient with acute lymphoblastic leukemia, who developed this infection at our center. Risk factors for the development of mucormycosis, clinical symptoms, radiology, laboratory results, and outcome were retrospectively evaluated.

Case: We describe a 6-years-old female patient with acute lymphoblastic leukemia. During the induction phase of therapy, the patient developed febrile neutropenia and did not respond to therapy with a combination of antibiotics and supportive treatment. Pansinusitis and orbitocellulitis developed. Examination of the biological material revealed that the etiological agent was a Rhizopus sp. The patient was treated with a combination of antimycotic drugs, but the infection disseminated to the central nervous system. She underwent radical surgical resection of the affected tissue. At this time, she is still under treatment with antimycotic and oncology agents, but is in remission of the main diagnosis and in good clinical condition.

Conclusion: Mucormycosis is an invasive fungal infection with high morbidity and mortality. Early diagnosis and initiation of effective therapy using a combination of amphotericin B administration and surgery are necessary to obtain a favorable outcome.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Keywords:

mucormycosis – acute leukemia – Rhizopus

Zdroje

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