The diagnostic pitfalls of mucormycosis

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Margherita Mauro
a:1:{s:5:"en_US";s:114:"Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria integrata, Verona";}

Giuliana Lo Cascio
Unità Operativa Complessa di Microbiologia e virologia, Dipartimento di Patologia e diagnostica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

Rita Balter
Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria integrata, Verona , Italy

Ada Zaccaron
Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria integrata, Verona , Italy

Elisa Bonetti
Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria integrata, Verona , Italy

Virgina Vitale
Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria integrata, Verona, Italy

Matteo Chinello
1Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria integrata, Verona, Italy

Massimiliano De Bortoli
1Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria integrata, Verona, Italy

Paolo Brazzarola
Endocrine Surgery Unit, Department of Surgery and Oncology, University and Hospital Trust of Verona, Verona, Italy

Costanza Bruno
Department of Radiology, Radiology Institute, Verona, Italy

Simone Cesaro
Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria integrata, Verona , Italy

Keywords

pediatric non Hodgkin lymphoma, fungal infection, mucormycosis

Abstract

 


Background Invasive mucormycosis is a very aggressive fungal disease among immunocompromised pediatric patients caused by saprophytic fungi that belong to the order of the Mucorales.


Case Report We describe a case of  of Lichtheimia corymbifera infection in a 15-year-old child with B-cell Non-Hodgkin Lymphoma (NHL) involving lung, kidney and thyroid that initially was diagnosed as probable aspergillosis delaying the effective therapy for mucormycosis.


Conclusions This case showed that also intensive chemotherapy with rituximab may represent a risk factor for mucormycosis infection. Liposomal amphotericin B and surgery  remain  key tools  for a successful treatment of this aggressive disease. 

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References

Bassetti M, Bouza E. Invasive mould infections in the ICU setting: complexities and solutions. J Antimicrob Chemother. 2017;72(Suppl 1):i39?i47 https://doi.org/10.1093/jac/dkx032 PMid:28355466
2. Francis JR, Villanueva P, Bryant P, Blyth CC. Mucormycosis in children: review and recommendations for management. J Pediatric Infect Dis Soc. 2017;00:1?6
3. Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis. 2012; 54(Suppl.1): 23-34 https://doi.org/10.1093/cid/cir866 PMid:22247442
4. Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RI, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005; 41:634-53 https://doi.org/10.1086/432579 PMid:16080086
5. Zaoutis TE, Roilides E, Chiou CC, Buchanan WL, Knudsen TA, Sarkisova TA, et al. Zygomycosis in children: a systematic review and analysis of reported cases. Pediatr Infect Dis J. 2007; 26:723-7 https://doi.org/10.1097/INF.0b013e318062115c
PMid:17848885
6. Otto WR, Pahud BA, Yin DE. Pediatric Mucormycosis: A 10-Year Systematic Review of Reported Cases and Review of the Literature. J Pediatric Infect Dis Soc. 2019; 8:342-350 https://doi.org/10.1093/jpids/piz007 PMid:31181136
7. Muggeo P, Calore E, Decembrino N, Frenos S, De Leonardis F, Colombini A, et al. Invasive mucormycosis in children with cancer: A retrospective study from the Infection Working Group of Italian Pediatric Hematology Oncology Association. Mycoses. 2019;62:165-170 https://doi.org/10.1111/myc.12862 PMid:30338581
8. Mussolin L, Lovisa F, Gallingani I, Cavallaro E, Carraro E, Damanti CC, et al. Minimal residual disease analysis in childhood mature B-cell leukaemia/lymphoma treated with AIEOP LNH-97 protocol with/without anti-CD20 administration. Br J Haematol. 2020; 189(3):e108-e111 https://doi.org/10.1111/bjh.16531 PMid:32080837
9. White TJ, Bruns TD, Lee SB, Taylor JW. Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. In Innis N, Gelfand J., White T, PCR Protocols: A Guide to Methods and Applications. Academic Press, New York. 1990; p. 315-322 https://doi.org/10.1016/B978-0-12-372180-8.50042-1 PMid:1696192
10. Pagano L, Offidani M, Fianchi L, Nosari A, Candoni A, Picardi M, et al. Mucormycosis in hematologic patients. Haematologica. 2004;89:207?214
11. Hung HC, Shen GY, Chen SC, Yeo KJ, Tsao SM, Lee MC, et al. Pulmonary Mucormycosis in a Patient with Systemic Lupus Erythematosus: A Diagnostic and Treatment Challenge. Case Rep Infect Dis. 2015;2015:478789 https://doi.org/10.1155/2015/478789 PMid:26185693 PMCid:PMC4491550
12. Cornely OA, Arikan-Akdagli S, Dannaoui E, Groll AH, Lagrou K, Chakrabarti A, et al. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2013. Clin Microbiol Infect. 2014;20 Suppl 3:5?26
https://doi.org/10.1111/1469-0691.12371 PMid:24479848
13. Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, Hochhegger B et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019;19(12):e405?e421
14. Thomas R, Madan R, Gooptu M, Hatabu H, Hammer MM. Significance of the Reverse Halo Sign in Immunocompromised Patients. AJR Am J Roentgenol. 2019;213:549?554 https://doi.org/10.2214/AJR.19.21273 PMid:31039026
15. Angebault C, Lanternier F, Dalle F, Schrimpf C, Ruopie AL, Dupuis A, et al. Prospective Evaluation of Serum ?-Glucan Testing in Patients With Probable or Proven Fungal Diseases. Open Forum Infect Dis. 2016;3:ofw128
https://doi.org/10.1093/ofid/ofw128 PMid:27419189 PMCid:PMC4942764
16. De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008;46:1813?1821
17. Groll AH, Castagnola E, Cesaro S, Dalle JH, Engelhard D, Hope W, et al. Fourth European Conference on Infections in Leukaemia (ECIL-4): guidelines for diagnosis, prevention, and treatment of invasive fungal diseases in paediatric patients with cancer or allogeneic haemopoietic stem-cell transplantation. Lancet Oncol. 2014;15:e327?e340
https://doi.org/10.1016/S1470-2045(14)70017-8

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Published
Oct 27, 2020
DOI https://doi.org/10.4084/mjhid.2020.079

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How to Cite

Mauro, M. (2020) “The diagnostic pitfalls of mucormycosis ”, Mediterranean Journal of Hematology and Infectious Diseases, 12(1), p. e2020079. doi: 10.4084/mjhid.2020.079.
Issue
Vol. 12 No. 1 (2020): Mediterranean Journal of Hematology and Infectious Diseases, Volume 12, 2020
Section
Case Reports
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