Intra-abdominal Rhizopus microsporus infection successfully treated by combined aggressive surgical, antifungal, and iron chelating therapy.
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.
Ting
Joseph Yuk
JY
Department of Paediatrics & Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
Chan
Shu-yan
SY
Lung
David Christopher
DC
Ho
Alvin Chi-chung
AC
Chiang
Alan Kwok-shing
AK
Ha
Shau-yin
SY
Tsoi
Nelson Nai-shun
NN
Chan
Godfrey Chi-fung
GC
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
D000935:Antifungal Agents; D007502:Iron Chelating Agents