Successful posaconazole salvage therapy for rhinocerebral mucormycosis in a child with leukemia. Review of the literature |
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| Institution: | 1. Pediatric Infectious Diseases Department, Hospital Infantil de México Federico Gómez, Mexico;2. Otorhinolaryngology Department, Hospital Infantil de México Federico Gómez, Mexico;3. Department of Pediatrics, Infectious Diseases Hospital, National Medical Center La Raza, Mexican Institute of Social Security, Mexico City, Mexico;1. Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico;2. National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland;3. Westat, Rockville, Maryland;4. Leidos Biomedical, Bethesda, Maryland;6. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico;5. Instituto Nacional de Pediatría, Mexico City, Mexico;7. Hospital Central “Dr. Ignacio Morones Prieto,” San Luis Potosí, México;1. Servicio de Microbiología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;2. Servicio de Neumología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;3. Servicio de Anatomía Patológica, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;4. Departamento de Ciencias Clínicas, Área de Microbiología, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain;1. Centro de Micología, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina;2. Sanatorio Municipal Dr. Julio Méndez, Buenos Aires, Argentina |
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| Abstract: | BackgroundMucormycosis is a fungal infection caused by species of the Mucorales order. These microorganisms are angioinvasive, with rapid disease progression and potentially lethal in its rhinocerebral form.Case reportWe present the case of a 12-year-old female with trisomy 21, acute lymphoblastic leukemia and diabetes, with fever and neutropenia who developed rhinocerebral mucormicosis. After treatment with amphotericin B lipid complex and extensive surgery, disease progressed and posaconazole was added as salvage treatment with full remission of the infection. Four years after diagnosis the patient continues without relapse of mucormycosis or leukemia.ConclusionsThis case highlights the use of posaconazole as either monotherapy or combined therapy. Although it is still debated, it can be considered an option for salvage treatment in children with non-responding mucormycosis, despite lack of standard dosage in pediatric patients. |
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| Keywords: | Mucormycosis Posaconazole Salvage treatment Mucormicosis Posaconazol Terapia de salvamento |
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