title: Mucormycosis in paediatric patients: demographics, risk factors and outcome of 12 contemporary cases.
abstract: Mucormycosis is associated with high morbidity and mortality and is perceived as an emerging fungal infection. However, contemporary paediatric data are limited. We present a series of paediatric cases of mucormycosis reported from Germany and Austria collected within a voluntary epidemiological survey through standardised, anonymized case report forms. Twelve cases were reported between January 2004 and December 2008 (six men; mean age: 12.6 years, range: 0.1-17 years). Mucormycosis was proven in nine, and probable in three cases. Isolates included Lichtheimia (syn. Absidia pro parte, Mycocladus) (five), Rhizopus (three) and Mucor (one) species. Infection was limited to soft tissue in three cases, the lung in two cases, and an infected thrombus in one case; rhinocerebral disease was found in three cases, and pulmonary-mediastinal, pulmonary-cerebral and soft tissue-cerebral involvement in one case each. All three patients with isolated soft tissue infection were cured, whereas seven of the remaining patients died (one patient without follow-up). The overall mortality rate was 67%. While these data cannot provide conclusive data on incidence and disease burden of mucormycosis in paediatric patients, they reflect the continuing threat of these infections to immunocompromised patients and the need for improved diagnosis and management.
authors.affiliation: Department of Pediatric Hematology/Oncology and Center for Bone Marrow Transplantation, University Hospital of Münster, Münster, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Däbritz
authors.forename: Andishe
authors.initials: A
authors.lastname: Attarbaschi
authors.forename: Kathrin
authors.initials: K
authors.lastname: Tintelnot
authors.forename: Nina
authors.initials: N
authors.lastname: Kollmar
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kremens
authors.forename: Friederike D
authors.initials: FD
authors.lastname: von Loewenich
authors.forename: Lothar
authors.initials: L
authors.lastname: Schrod
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Schuster
authors.forename: Uwe
authors.initials: U
authors.lastname: Wintergerst
authors.forename: Michael
authors.initials: M
authors.lastname: Weig
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehrnbecher
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Groll
mesh_terms: D000293:Adolescent; D001317:Austria / Q000453:epidemiology; D002648:Child; D003710:Demography; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D009090:Mucorales / Q000145:classification / Q000302:isolation & purification*; D009091:Mucormycosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome