scholarly journals Recurrent rhino-ocular-cerebral mucormycosis in a leukemic child: a case report and review of pediatric literature

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Francesco De Leonardis ◽  
Teresa Perillo ◽  
Giuseppe Giudice ◽  
Gianfranco Favia ◽  
Nicola Santoro
Keyword(s):  
Case Report ◽  
Acute Lymphoblastic Leukemia ◽  
Fungal Infection ◽  
Pediatric Patient ◽  
Antifungal Therapy ◽  
Lymphoblastic Leukemia ◽  
Aggressive Treatment ◽  
Lethal Infection ◽  
Leukemic Child ◽  
Prompt Diagnosis

Mucormycosis is an uncommon but severe fungal infection, typically observed in immunocompromized patients. We report a case of acute lymphoblastic leukemia complicated by rhino-oculo-cerebral mucormycosis in a pediatric patient. Combination lipid polyeneechinocandin therapy, along with surgical debridement appeared to be effective. Nevertheless, a severe relapse occurred during posaconazole prophylaxis; antifungal therapy, hemimaxillectomy and suspension of chemotherapy were performed. Although mucormycosis is a frequently lethal infection, prompt diagnosis and aggressive treatment can be successful even in cases of relapse.

Blinatumomab-related pneumatosis intestinalis in a pediatric patient with relapsed acute lymphoblastic leukemia: A case report

2021 ◽  
pp. 107815522110157
Author(s):  
Sung Eun Kim ◽  
So Mi Lee ◽  
Ji Yoon Kim
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Acute Lymphoblastic Leukemia ◽  
B Cell ◽  
Pediatric Patient ◽  
Lymphoblastic Leukemia ◽  
Good Condition ◽  
Gastrointestinal Symptoms ◽  
Pneumatosis Intestinalis ◽  
First Case

Introduction Pneumatosis intestinalis is characterized by air in the subserosal or submucosal layer of the intestine, with the severity ranging from mild and asymptomatic to symptomatic with serious conditions such as intestinal ischemia and perforation requiring surgery. Although several etiologies, including those from conventional chemotherapy agents and molecular target agents, have been suggested, blinatumomab-related pneumatosis intestinalis is quite rare. Case report An 11-year-old girl with history of B-cell ALL presented with bone marrow relapse 3 years after completion of initial chemotherapy. Reinduction chemotherapy and blinatumomab as post-reinduction consolidation were initiated. On day 28 of blinatumomab therapy, pneumatosis intestinalis from the ascending colon to the hepatic flexure was found incidentally on abdominal computed tomography. Management and outcome: After withholding blinatumomab therapy for 1 month, pneumatosis intestinalis improved significantly without abnormal gastrointestinal symptoms. Blinatumomab was resumed and safely completed. The computed tomography performed 4 months later showed complete resolution of pneumatosis intestinalis. The patient has been in good condition for over 1 year to date. Discussion To our knowledge, this is the first case report of pneumatosis intestinalis after blinatumomab therapy in a pediatric patient with relapsed precursor B-cell acute lymphoblastic leukemia. Herein, we highlight the importance of early detection of pneumatosis intestinalis through imaging follow-up during blinatumomab therapy.

scholarly journals As a Rare Site of Invasive Fungal Infection, Chronic Granulomatous Aspergillus Synovitis: A Case Report

2013 ◽  
Vol 5 (1) ◽  
pp. e2013043 ◽  
Author(s):  
Aylin Canbolat Ayhan ◽  
Korhan Ozkan ◽  
Cetin Timur ◽  
Birol Aktaş ◽  
Ayse Bahar Ceyran
Keyword(s):  
Case Report ◽  
Acute Lymphoblastic Leukemia ◽  
Fungal Infection ◽  
Rare Case ◽  
Case Reports ◽  
Lymphoblastic Leukemia ◽  
Invasive Disease ◽  
Immune Systems ◽  
Osteoarticular Infections ◽  
Rare Site

Aspergillus can causes invasive disease of various organs especially in patients with weakened immune systems. Aspergillus synovitis and arthritis are uncommon types of involvement due to this infection. Approches to fungal osteoarticular infections are based on only case reports. This paper presents a rare case of chronic granulomatous Aspergillus synovitis in an immunocompromised 5-year old girl who was treated for acute lymphoblastic leukemia.

#26: Rhino-Orbital Mucormycosis in Immunocompromised Children: Treatment Outcomes of Three Cases

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S23-S23
Author(s):  
G Valdés ◽  
M Martínez ◽  
A Morayta
Keyword(s):  
Risk Factors ◽  
Acute Lymphoblastic Leukemia ◽  
Fungal Infection ◽  
Amphotericin B ◽  
Antifungal Therapy ◽  
Early Identification ◽  
Liposomal Amphotericin ◽  
Lymphoblastic Leukemia ◽  
Case Series ◽  
Liposomal Amphotericin B

Abstract Background Mucormycosis is an aggressive opportunistic fungal infection of the family Mucoraceae, including the genera Mucor, Absidia, and Rhizopus. It is the third most common cause of invasive fungal infection, with low incidence, but high mortality (50–90%), and it usually presents in immunocompromised hosts. The fungus spores are ubiquitous in nature and are found in soil, air, and on decaying vegetation. Individuals get infected following inhalation of spores, ingestion, or contamination of wounds. Rhino-orbito-cerebral mucormycosis is the most common form of illness in children. An early diagnosis and a multidisciplinary approach to treatment are necessary to prevent mortality. Methods We present a case series of three immunocompromised children with rhino-orbital mucormycosis in Nacional Medical Center “20 de Noviembre” from 2015 to 2019. We describe time to diagnosis, start of antifungal therapy, surgery involvement, and patient outcomes. Results Patient 1 was a 9-year-old girl with aplastic anemia who developed right palpebral swelling (day 1 of initial symptoms) and was initially diagnosed with preseptal cellulitis. On day 5, a necrotic area appeared in the right inner canthus. Paranasal sinus CT scan showed opacified ethmoidal sinus. Liposomal amphotericin B therapy was started. At day 7, surgical debridement was performed. At day 18, the patient died and the culture of the debrided tissue showed Mucor ramosissimus. Patient 2 was a 15-year-old boy with acute lymphoblastic leukemia who developed a necrotic area in right side of the nose and palate (day 1). Liposomal amphotericin B therapy was initiated. At day 3 and 6, surgery was performed. At day 8, cultures resulted in Rhizopus oryzae, and treatment with caspofungin was added. He had progression of the infection, requiring multiple interventions. Antifungal therapy consisted of 75 days with amphotericin B and 67 days with caspofungin, with resolution. At day 152, he had a event of neutropenia and fever and died of septic shock Patient 3 was a 16-year-old girl with acute lymphoblastic leukemia who developed a necrotic lesion on the palate and right side of the nose (day 1). Direct examination of the lesion showed hyaline, non-septated hyphae. Amphotericin B therapy was initiated and surgery was performed at day 3. By day 7, there was good clinical evolution and resolution the infection. She died at day 12 because of intestinal bleeding and hypovolemic shock. Conclusions The diagnosis and treatment of mucormycosis remains a challenge. Clinical suspicion should be high in patients with risk factors, and early identification and prompt treatment with antifungals and surgical debridement can reduce mortality and improve the prognosis. The poor outcomes of the patients in this case series were mainly due to complications of the underlying disease and not because of mucormycosis. However, in the first case, delayed diagnosis and treatment might have contributed to the unfavorable outcome. The treatment of choice is liposomal amphotericin B. In case 2, a second antifungal therapy included caspofungin due to isolation of R. oryzae, sensitive to echinocandins. Posaconazole can be considered as an alternative option, but it is not available at our institution. Early identification of clinical manifestations and early multidisciplinary treatment with surgical services and antifungal are needed to eliminate the infection. Risk factors must be modified to increase patient survival.

Isavuconazole Treatment of Cerebral and Pulmonary Aspergillosis in a Pediatric Patient With Acute Lymphoblastic Leukemia: Case Report and Review of Literature

2019 ◽  
Vol 42 (6) ◽  
pp. e469-e471 ◽  
Author(s):  
Francesco De Leonardis ◽  
Chiara Novielli ◽  
Benedetta Giannico ◽  
Maria Addolorata Mariggiò ◽  
Elio Castagnola ◽  
...  
Keyword(s):  
Case Report ◽  
Acute Lymphoblastic Leukemia ◽  
Pediatric Patient ◽  
Lymphoblastic Leukemia ◽  
Review Of Literature ◽  
Pulmonary Aspergillosis
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