title: Successful treatment of disseminated mucormycosis in a neutropenic patient with T-cell acute lymphoblastic leukaemia.
abstract: Mucormycosis is a rare angioinvasive fungal infection, more commonly seen in immunosuppressed patients, with reported mortality rates of 95% in disseminated disease. We present a case report of a patient with T-cell acute lymphoblastic leukaemia who developed disseminated infection with mucormycosis (involving the pancreas, left occipital lobe, right lower lobe of lung, appendix and right kidney) after having completed induction and consolidation chemotherapy. Growth of Lichtheimia corymbifera was initially isolated following a right pleural tap with fungal elements identified repeatedly on subsequent pathology specimens. Following radical surgical debridement and concurrent treatment with combination antifungal therapy, the patient survived. This case demonstrates that aggressive multisite surgical de-bulking of disseminated fungal foci, in conjunction with combination antifungal therapy and reversal of immunosuppression, can result in survival despite the grave prognosis associated with disseminated mucormycosis.
authors.affiliation: Department of Paediatrics, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Guymer
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Khurana
authors.forename: Ram
authors.initials: R
authors.lastname: Suppiah
authors.forename: Iain
authors.initials: I
authors.lastname: Hennessey
authors.forename: Celia
authors.initials: C
authors.lastname: Cooper
mesh_terms: D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D009091:Mucormycosis / Q000473:pathology / Q000628:therapy*; D009503:Neutropenia / Q000150:complications*; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D012074:Remission Induction
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