Disseminated Mucormycosis in Immunocompromised Children: Are New Antifungal Agents Making a Difference? A Multicenter Retrospective Study.

antifungal agents children immunocompromised invasive fungal infections leukemia mucormycosis pediatric hematology oncology

Journal

Journal of fungi (Basel, Switzerland)
ISSN: 2309-608X
Titre abrégé: J Fungi (Basel)
Pays: Switzerland
ID NLM: 101671827

Informations de publication

Date de publication:
25 Feb 2021
Historique:
received: 30 01 2021
revised: 18 02 2021
accepted: 19 02 2021
entrez: 6 3 2021
pubmed: 7 3 2021
medline: 7 3 2021
Statut: epublish

Résumé

Mucormycosis is a life-threatening infection with a tendency for angioinvasion that may lead to progressive dissemination. Disseminated mucormycosis, defined as the involvement of two or more non-contiguous sites, is rare in children, and data concerning its management and outcome are scarce. The aim of this study was to assess the contemporary management strategies and outcomes of disseminated mucormycosis in the pediatric population. We conducted a retrospective search in six large tertiary medical centers for all cases of disseminated mucormycosis that occurred between 2009-2020 in patients aged 1-20 years. Twelve cases were identified. Underlying conditions included hematological malignancies ( Disseminated mucormycosis is a life-threatening and often fatal disease, and improved diagnostic and therapeutic strategies are needed. Nevertheless, in this population-based study, five patients (42%) were salvaged through combined liposomal amphotericin/triazole treatment and extensive surgical interventions.

Sections du résumé

BACKGROUND BACKGROUND
Mucormycosis is a life-threatening infection with a tendency for angioinvasion that may lead to progressive dissemination. Disseminated mucormycosis, defined as the involvement of two or more non-contiguous sites, is rare in children, and data concerning its management and outcome are scarce. The aim of this study was to assess the contemporary management strategies and outcomes of disseminated mucormycosis in the pediatric population.
METHODS METHODS
We conducted a retrospective search in six large tertiary medical centers for all cases of disseminated mucormycosis that occurred between 2009-2020 in patients aged 1-20 years.
RESULTS RESULTS
Twelve cases were identified. Underlying conditions included hematological malignancies (
CONCLUSIONS CONCLUSIONS
Disseminated mucormycosis is a life-threatening and often fatal disease, and improved diagnostic and therapeutic strategies are needed. Nevertheless, in this population-based study, five patients (42%) were salvaged through combined liposomal amphotericin/triazole treatment and extensive surgical interventions.

Identifiants

pubmed: 33668990
pii: jof7030165
doi: 10.3390/jof7030165
pmc: PMC7996519
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Sarah Elitzur (S)

The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva 4920235, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

Salvador Fischer (S)

The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva 4920235, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

Nira Arad-Cohen (N)

Pediatric Hematology-Oncology Department, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa 3109601, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel.

Assaf Barg (A)

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Division of Pediatric Hematology, Oncology and BMT, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan 5262161, Israel.

Miriam Ben-Harosh (M)

Department of Pediatric Hematology-Oncology, Soroka Medical Center, Ben Gurion University, Beer Sheva 8489501, Israel.

Dana Danino (D)

Pediatric Infectious Disease Unit, Soroka Medical Center, Ben Gurion University, Beer Sheva 8489501, Israel.

Ronit Elhasid (R)

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Department of Pediatric Hemato-Oncology, Sourasky Medical Center, Tel Aviv 6423906, Israel.

Aharon Gefen (A)

Pediatric Hematology-Oncology Department, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa 3109601, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel.

Gil Gilad (G)

The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva 4920235, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

Itzhak Levy (I)

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Pediatric Infectious Disease Unit; Schneider Children's Medical Center, Petah Tikva 4920235, Israel.

Yael Shachor-Meyouhas (Y)

Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel.
Pediatric Infectious Disease Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa 3109601, Israel.

Sigal Weinreb (S)

Pediatric Hematology-Oncology, Hadassah Hebrew University Medical Center, Jerusalem 9112000, Israel.

Shai Izraeli (S)

The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva 4920235, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

Shlomit Barzilai-Birenboim (S)

The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva 4920235, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

Classifications MeSH