title: Successful Treatment of Rhino-Orbital-Cerebral Mucormycosis in a Child With Leukemia.
abstract: Rhino-orbital-cerebral mucormycosis (ROCM) is a rare fulminant opportunistic fungal infection that despite relevant treatment has high mortality. We present a case of a 3-year-old girl with acute lymphoblastic leukemia and ROCM, who was treated successfully with excessive surgery, systemic antifungal treatment with amphotericin B (AmB), posaconazole, and terbinafine as well as hyperbaric oxygen. Surgery included, beside extracranial and intracranial removal of infected areas, endoscopic sinus and skull base surgery with local AmB installation and in addition placement of an Ommaya reservoir for 114 intrathecal administrations of AmB. In addition, we review the literature of ROCM in pediatric patients with hematological diseases.
authors.affiliation: Departments of *Neurosurgery ‡Otorhinolaryngology, Head and Neck Surgery & Audiology §Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet †Unit for Mycology, Microbiology and Infection Control, Statens Serum Institute, Copenhagen, Denmark.
authors.forename: Thorbjørn S R
authors.initials: TSR
authors.lastname: Jensen
authors.forename: Maiken C
authors.initials: MC
authors.lastname: Arendrup
authors.forename: Christian
authors.initials: C
authors.lastname: von Buchvald
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Frandsen
authors.forename: Marianne
authors.initials: M
authors.lastname: Juhler
authors.forename: Ulrikka
authors.initials: U
authors.lastname: Nygaard
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001921:Brain / Q000382:microbiology / Q000473:pathology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D009091:Mucormycosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D009281:Naphthalenes / Q000627:therapeutic use; D009666:Nose / Q000382:microbiology / Q000473:pathology; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D009915:Orbit / Q000382:microbiology / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000628:therapy; D000077291:Terbinafine; D014230:Triazoles / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B; D000077291:Terbinafine