Rhinocerebral mucormycosis in a boy with recurrent acute lymphoblastic leukemia: long-term survival with systemic antifungal treatment.
Rhinocerebral mucormycosis is rare in hematologic malignancies and usually leads to death within weeks. In contrast, chronic rhinocerebral mucormycosis takes a slowly progressive course and has not been reported in hematologic malignancies in children so far. The authors report the long-term survival of a boy with rhinocerebral mucormycosis in a relapse of acute lymphoblastic leukemia after allogeneic cord blood transplantation. The disease started acutely but took a chronic course thereafter. No surgical debridement was performed because of extensive involvement of the sinuses, orbits, and cerebrum. His long-term survival of 15 months is attributed to the long-range administration of liposomal amphotericin B, early neutrophil recovery, and slow progression of the relapsing acute lymphoblastic leukemia.
Wehl
Goetz
G
Department of Pediatrics, University of Innsbruck, Austria. goetz.wehl@uibk.ac.at
Hoegler
Wolfgang
W
Kropshofer
Gabriele
G
Meister
Bernhard
B
Fink
Franz-Martin
FM
Heitger
Andreas
A
D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001927:Brain Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D036101:Cord Blood Stem Cell Transplantation; D018572:Disease-Free Survival; D006801:Humans; D007223:Infant; D008081:Liposomes; D008297:Male; D009091:Mucormycosis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D009364:Neoplasm Recurrence, Local; D010254:Paranasal Sinus Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D014184:Transplantation, Homologous
D000935:Antifungal Agents; D008081:Liposomes; D000666:Amphotericin B