Gangrenous Cutaneous Mucormycosis in a Child with a Solid Organ Transplant: A Case Report and Review of the Literature

Boyd, Alan S.; Wiser, Britt; Sams, Hunter H.; King, Lloyd E.

doi:10.1046/j.1525-1470.2003.20508.x

Cited by 36 publications

(28 citation statements)

References 22 publications

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“…18,2005 NOVEL PERSPECTIVES ON MUCORMYCOSIS 557 temporarily disrupts the capacity of transferrin to bind iron (9). Therefore, the increased susceptibility to mucormycosis of patients with diabetic ketoacidosis is likely due at least in part to an elevation in available serum iron during diabetic ketoacidosis.…”

Section: Role Of Iron In Pathogenesismentioning

confidence: 99%

“…Secondary vascular invasion may also lead to hematogenously disseminated infection of the deep organs. Cutaneous and subcutaneous disease may lead to necrotizing fasciitis, which has a mortality approaching 80% (18,80,115,124). However, isolated cutaneous mucormycosis (i.e., not disseminated disease) has a favorable prognosis and a low mortality if aggressive surgical debridement is done promptly (4).…”

Section: Epidemiology and Disease Manifestationsmentioning

confidence: 99%

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Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

2005

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Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. These infections are becoming increasingly common, yet survival remains very poor. A greater understanding of the pathogenesis of the disease may lead to future therapies. For example, it is now clear that iron metabolism plays a central role in regulating mucormycosis infections and that deferoxamine predisposes patients to mucormycosis by inappropriately supplying the fungus with iron. These findings raise the possibility that iron chelator therapy may be useful to treat the infection as long as the chelator does not inappropriately supply the fungus with iron. Recent data support the concept that high-dose liposomal amphotericin is the preferred monotherapy for mucormycosis. However, several novel therapeutic strategies are available. These options include combination therapy using lipid-based amphotericin with an echinocandin or with an azole (largely itraconazole or posaconazole) or with all three. The underlying principles of therapy for this disease remain rapid diagnosis, reversal of underlying predisposition, and urgent surgical debridement

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Section: Role Of Iron In Pathogenesismentioning

confidence: 99%

Section: Epidemiology and Disease Manifestationsmentioning

confidence: 99%

Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management

2005

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“…[1][2][3][4][5][6][7][8] Although numerous species within this order are associated with mucormycosis, the Rhizopus subsp is the most common cause. 1,3,4,6 Spores are most often disseminated through the air via inhalation, but transmission may also occur by ingestion or direct traumatic skin inoculation.…”

Section: Commentmentioning

confidence: 99%

“…2,3 Clinically, there are 5 categories of mucormycosis infection: rhinocerebral (most common), pulmonary, disseminated, gastrointestinal, and cutaneous. [1][2][3][4][5][6][7][8] Otolaryngologists are all too familiar with the rhinocerebral presentation.…”

Section: Commentmentioning

confidence: 99%

Facial Cutaneous Mucormycosis in a Full-term Infant

Dave

Vivero

Roy

2008

Arch Otolaryngol Head Neck Surg

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Mucormycosis is a rare and potentially fatal fungal infection that most commonly affects the immunocompromised population. Although originally described by Paltauf in 1885 (D. G. Finn as cited by Vessely et al(1)((p573)) and A. M. Marchevsky as cited by Oh and Notrica(2)((p1607))), it was not until 1955 that Harris (as cited by Vessely et al(1)((p573))) reported the first case of a mucormycosis survivor. In recent years, the number of immunosuppressed patients has increased partly owing to the widespread implementation of organ transplantation and the increasing prevalence of human immunodeficiency virus infection. Consequently, the incidence of mucormycosis has also increased, especially in pediatric patients. In the setting of immunocompromise, a high index of suspicion is required to accurately diagnose and treat this potentially lethal infection in a timely fashion. To our knowledge, we report the first case of facial cutaneous mucormycosis in an infant, who also represents the first reported neonate or infant to survive a cutaneous mucormycosis infection of the head and neck.

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“…Infections generally occur in immunocompromised patients with conditions such as neutropenia, diabetes or hematologic malignant disease. 1,3 Clinical manifestations may be classified as rhinocerebral, pulmonary, gastrointestinal, cutaneous or disseminated.…”

mentioning

confidence: 99%