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Treatment of intestinal and hepatic mucormycosis in an immunocompromized child
Author(s) -
Lüer Sonja,
Berger Steffen,
Diepold Miriam,
Duppenthaler Andrea,
von Gunten Michael,
Mühlethaler Konrad,
Wolf Rainer,
Aebi Christoph
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21918
Subject(s) - medicine , posaconazole , mucormycosis , zygomycosis , neutropenia , vincristine , surgery , pediatric cancer , antifungal , febrile neutropenia , radiology , gastroenterology , chemotherapy , cancer , cyclophosphamide , dermatology , voriconazole , amphotericin b
During ALL chemotherapy, a 4‐year‐old patient presented with febrile neutropenia and abdominal pain. Ultrasound examinations were repeatedly normal. Computerized tomography on day 7 demonstrated appendicitis and multiple hepatic foci identified as mucormycosis ( Absidia corymbifera ). Successful outcome was achieved by aggressive re‐surgery, long‐term antifungal therapy with serum level‐monitored posaconazole, and recovery of neutrophil counts. Considering the interference of posaconazole with CYP3A4, vincristine was administered during 72 hr posaconazole windows. Pediatric intestinal mucormycosis, still associated with a >70% case‐fatality rate, calls for early imaging and surgery to establish the diagnosis, reduce the fungal mass, and provide a rationale for using posaconazole. Pediatr Blood Cancer 2009;52:872–874. © 2009 Wiley‐Liss, Inc.