title: Intra-abdominal Rhizopus microsporus infection successfully treated by combined aggressive surgical, antifungal, and iron chelating therapy.
abstract: Zygomycetes are widely distributed in the environment as inhabitants of soil and decaying matter. On rare occasions, these organisms can cause invasive infections in immunocompromised hosts. As zygomycetes are resistant to most conventional antifungal agents, its infection is often fatal. We report 2 cases of unusual intra-abdominal Rhizopus microsporus infection in children with acute leukemia as a result of an unprecedented outbreak due to oral intake of contaminated allopurinol tablets and ready-to-eat food items. Among the 2 patients, one of them survived after aggressive combined surgical, antifungal (AmBisome, Caspofungin, and Posaconazole) and iron chelation therapy.
authors.affiliation: Department of Paediatrics & Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Joseph Yuk
authors.initials: JY
authors.lastname: Ting
authors.forename: Shu-yan
authors.initials: SY
authors.lastname: Chan
authors.forename: David Christopher
authors.initials: DC
authors.lastname: Lung
authors.forename: Alvin Chi-chung
authors.initials: AC
authors.lastname: Ho
authors.forename: Alan Kwok-shing
authors.initials: AK
authors.lastname: Chiang
authors.forename: Shau-yin
authors.initials: SY
authors.lastname: Ha
authors.forename: Nelson Nai-shun
authors.initials: NN
authors.lastname: Tsoi
authors.forename: Godfrey Chi-fung
authors.initials: GC
authors.lastname: Chan
mesh_terms: D000005:Abdomen / Q000382:microbiology* / Q000601:surgery; D000935:Antifungal Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D006801:Humans; D016867:Immunocompromised Host; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D009091:Mucormycosis / Q000209:etiology / Q000276:immunology* / Q000628:therapy*; D009503:Neutropenia / Q000139:chemically induced; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000503:physiopathology; D012233:Rhizopus
chemical_list: D000935:Antifungal Agents; D007502:Iron Chelating Agents