title: Mucormycosis in children: a study of 22 cases in a Mexican hospital.
abstract: We present a single-centre, retrospective study (1985-2012) of 22 cases of mucormycosis in children. A total of 158 mucormycosis cases were identified, of which 22 (13.96%) were children. The mean age of the children was 10.3 years (range: 6 months-18 years), and 59% of the infections occurred in males. The rhinocerebral form was the main clinical presentation (77.27%), followed by the primary cutaneous and pulmonary patterns. The major underlying predisposing factors were diabetes mellitus in 68.18% of the patients and haematologic diseases in 27.7% of the patients. The cases were diagnosed by mycological tests, with positive cultures in 95.4% of the patients. Rhizopus arrhizus was the foremost aetiologic agent in 13/22 cases (59.1%). In 21 cultures, the aetiologic agents were identified morphologically and by molecular identification. In 10 cultures, the internal transcribed spacer region of the ribosomal DNA was sequenced. Clinical cure and mycological cure were achieved in 27.3% cases, which were managed with amphotericin B deoxycholate and by treatment of the underlying conditions.
authors.affiliation: Mycology Department, Dermatology Service, Hospital General de México (HGM), Reus, Spain.
authors.forename: Alexandro
authors.initials: A
authors.lastname: Bonifaz
authors.forename: Andrés
authors.initials: A
authors.lastname: Tirado-Sánchez
authors.forename: Luz
authors.initials: L
authors.lastname: Calderón
authors.forename: Raúl
authors.initials: R
authors.lastname: Romero-Cabello
authors.forename: Juan
authors.initials: J
authors.lastname: Kassack
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Ponce
authors.forename: Carlos
authors.initials: C
authors.lastname: Mena
authors.forename: Alberto
authors.initials: A
authors.lastname: Stchigel
authors.forename: Josep
authors.initials: J
authors.lastname: Cano
authors.forename: Josep
authors.initials: J
authors.lastname: Guarro
mesh_terms: D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004271:DNA, Fungal / Q000235:genetics; D003840:Deoxycholic Acid / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico; D009091:Mucormycosis / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D012233:Rhizopus / Q000302:isolation & purification / Q000472:pathogenicity; D017422:Sequence Analysis, DNA
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D004338:Drug Combinations; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination
keywords: Mucormycosis; children; diabetes mellitus; haematological malignancy; rhinocerebral; zygomycosis