Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2013; 34(04): 313-316
DOI: 10.4103/0971-5851.125254
CASE REPORT

Successful outcome of mucormycosis in two children on induction therapy for acute lymphoblastic leukemia

Anshul Gupta
Department of Pediatric Hematology and Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
,
Sandeep Jain
Department of Pediatric Hematology and Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
,
Charu Agrawal
Department of Microbiology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
,
Gauri Kapoor
Department of Pediatric Hematology and Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
› Author Affiliations
› Further Information
  PDF Download Permissions and Reprints

Abstract

Zygomycetes are one of the less common causes of invasive fungal infections in patients with the hematological malignancies. We report two cases of acute lymphoblastic leukemia in the pediatric age group, complicated by disseminated cutaneous mucormycosis during induction chemotherapy. In one of our cases, cutaneous mucormycosis progressed to osteomyelitis of the proximal ulna while in the other it disseminated to lungs and distant cutaneous site. Aggressive treatment, which included intravenous administration of amphotericin B; radical surgical intervention in the form of serial wound debridement in the former and wedge pulmonary resection in the later, allowed successful salvage, and administration of planned anti-leukemia treatment in both of our cases. High index of suspicion, timely diagnosis, and appropriate treatment are key components of a successful outcome.

Keywords

Children - cutaneous - leukemia - mucormycosis


Publication History

Article published online:
19 July 2021

© 2013. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Eucker J, Sezer O, Graf B, Possinger K. Mucormycoses. Mycoses 2001;44:253-60.
  • 2 Linder N, Keller N, Huri C, Kuint J, Goldshmidt-Reuven A, Barzilai A. Primary cutaneous mucormycosis in a premature infant: Case report and review of the literature. Am J Perinatol 1998;15:35-8.
  • 3 Zirak C, Brutus JP, De Mey A. Atypical cause of forearm skin ulceration in a leukaemic child: Mucormycosis. A case report. Acta Chir Belg 2005;105:551-3.
  • 4 Page AV, Evans AJ, Snell L, Liles WC. Primary cutaneous mucormycosis in a lung transplant recipient: Case report and concise review of the literature. Transpl Infect Dis 2008;10:419-25.
  • 5 de Mol P, Meis JF. Disseminated Rhizopus microsporus infection in a patient on oral corticosteroid treatment: A case report. Neth J Med 2009;67:25-8.
  • 6 Pagano L, Offidani M, Fianchi L, Nosari A, Candoni A, Piccardi M, et al. Mucormycosis in hematologic patients. Haematologica 2004;89:207-14.
  • 7 Rogers TR. Treatment of zygomycosis: Current and new options. J Antimicrob Chemother 2008;61 Suppl 1:i35-40.
  • 8 Ibrahim AS, Edwards JE Jr, Filler SG. Zygomycosis. In: Dismuskes WE, Pappas PG, Sobel JD, editors. Clinical Mycology. New York, NY: Oxford University Press; 2003. p. 241-51.
  • 9 Ribeiro NF, Cousin GC, Wilson GE, Butterworth DM, Woodwards RT. Lethal invasive mucormycosis: Case report and recommendations for treatment. Int J Oral Maxillofac Surg 2001;30:156-9.
  • 10 Sammassimo S, Mazzotta S, Tozzi M, Gentili S, Lenoci M, Santopietro R, et al. Disseminated mucormycosis in a patient with acute myeloblastic leukemia misdiagnosed as infection by Enterococcus faecium. J Clin Microbiol 2004;42:487-9.
  • 11 Kontoyiannis DP, Lionakis MS, Lewis RE, Chamilos G, Healy M, Perego C, et al. Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy: A case-control observational study of 27 recent cases. J Infect Dis 2005;191:1350-60.
  • 12 Jones NF, Shin EK, Eo S, Starzl TE. Successful salvage of mucormycosis infection of the forearm and osteomyelitis of the ulna. Hand (N Y) 2008;3:332-6.