Successful treatment of pulmonary mucormycosis in two pediatric hematopoietic stem cell transplant patients

Pediatr Transplant. 2018 Nov;22(7):e13270. doi: 10.1111/petr.13270. Epub 2018 Jul 16.

Abstract

Pulmonary mucormycosis diagnosed immediately after hematopoietic stem cell transplantation frequently portends a poor prognosis. However, here we describe two cases in children that were treated successfully to highlight the efficacy of a multidisciplinary approach. Despite diagnosis in the immediate post-transplant period and requirement for ongoing immunosuppression to prevent or treat GVHD, both are long-term survivors due to early surgical debridement with transfusion support and prompt initiation of targeted antifungal therapy. In the absence of evidence-based treatment guidelines, survival of pulmonary mucormycosis is achievable even in high-risk patients with a multidisciplinary team to guide management.

Keywords: infections in immunocompromised hosts; invasive fungal disease; mucormycosis; stem cell transplantation.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antifungal Agents / therapeutic use
  • Child
  • Combined Modality Therapy
  • Debridement
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Lung Diseases, Fungal / diagnosis
  • Lung Diseases, Fungal / immunology
  • Lung Diseases, Fungal / therapy*
  • Male
  • Mucormycosis / diagnosis
  • Mucormycosis / immunology
  • Mucormycosis / therapy*
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / immunology
  • Opportunistic Infections / therapy*

Substances

  • Antifungal Agents
  • Immunosuppressive Agents