title: Liposomal amphotericin B and surgery as successful therapy for pulmonary Lichtheimia corymbifera zygomycosis in a pediatric patient with acute promyelocytic leukemia on antifungal prophylaxis with posaconazole.
abstract: Pulmonary zygomycosis, also referred to as mucormycosis, is a fungal infection of lungs caused by fungi of the order Mucorales in the class of Zygomycetes. It is usually associated with high morbidity and mortality. Here, we report the case of a 14-year-old girl with pediatric acute promyelocytic leukemia (APL) on antifungal prophylaxis with posaconazole, who developed pulmonary Lichtheimia corymbifera (formerly Absidia corymbifera) zygomycosis. She was successfully treated by means of liposomal amphotericin B (L-AmB) and surgery. To our knowledge, this is the first published report on pediatric APL and pulmonary zygomycosis in the English language literature. At present, the patient is in complete remission of her APL and without any signs of recurrence of zygomycosis. This report suggests that efficient diagnostics, increased physician awareness, and reliance on adjunctive surgical therapy can result in a favorable outcome of pulmonary zygomycosis in immunocompromised children with hematological malignancies.
authors.affiliation: Centre of Hematology and Oncology, Children's Hospital, Vilnius University Hospital Santariskiu Clinics, Santariskiu street 4, LT-08406 Vilnius, Lithuania. grazina.kleinotiene@vuvl.lt
authors.forename: Grazina
authors.initials: G
authors.lastname: Kleinotiene
authors.forename: Gintas
authors.initials: G
authors.lastname: Posiunas
authors.forename: Juozas
authors.initials: J
authors.lastname: Raistenskis
authors.forename: Edvardas
authors.initials: E
authors.lastname: Zurauskas
authors.forename: Sigita
authors.initials: S
authors.lastname: Stankeviciene
authors.forename: Valentina
authors.initials: V
authors.lastname: Daugelaviciene
authors.forename: Maciej
authors.initials: M
authors.lastname: Machaczka
mesh_terms: D020095:Absidia; D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications*; D008172:Lung Diseases, Fungal / Q000276:immunology / Q000628:therapy*; D009091:Mucormycosis / Q000209:etiology* / Q000276:immunology; D011013:Pneumonectomy; D014230:Triazoles / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C068538:liposomal amphotericin B; C101425:posaconazole; D000666:Amphotericin B