Hyperthyroidism Secondary to Disseminated Mucormycosis in a Child with Acute Lymphoblastic Leukemia: Case Report and a Review of Published Reports

Abstract

Thyroiditis due to fungal infection is an extremely rare cause of hyperthyroidism. The most common etiological factor of thyroiditis is Aspergillus. Infections due to members of the Mucorales have been an increasing clinical problem in recent years, and the prognosis in generalized infections due to those fungi is usually very poor. No hyperthyroidism in a child with thyroiditis due to mucormycosis has been reported in the literature so far. We describe a clinical course of generalized mucormycosis with thyroid involvement in a 12-year-old girl treated for acute lymphoblastic leukemia. The child underwent a hyperthyroidism connected with thyroid involvement due to a fungal process. The diagnosis was based on the clinical signs, laboratory findings and typical ultrasound scan; however, later attempt to amplify the fungi DNA from the tissue block has failed. The child died because of multiorgan failure due to general fungal infection 49 days after the invasive fungal infection was diagnosed. The generalized mucormycosis is always connected with poor prognosis and the mortality is high.

The infectious thyroid nodule: A case report of mucormycosis associated with ibrutinib therapy

“…is exceedingly rare with only 11 previous cases reported in the literature. Only two previously reported cases, a renal transplant patient in India and a child undergoing treatment for acute lymphoblastic leukemia in Poland, involved isolated thyroid disease [4, 5]. The others had thyroid involvement in the context of disseminated infection [6].…”

Mucormycosis of the thyroid gland: A cataclysmic event in renal allograft recipient

“…Recent review reports only 10 cases of thyroid involvement and only 1 among them was a renal allograft recipient. [ 11 ] He had a disseminated mucormycosis and died due to sepsis. [ 2 11 ] The rhinocerebral, pulmonary, and gastrointestinal forms are the common forms of mucormycosis.…”

“…[ 11 ] He had a disseminated mucormycosis and died due to sepsis. [ 2 11 ] The rhinocerebral, pulmonary, and gastrointestinal forms are the common forms of mucormycosis. It can also involve the liver, genitourinary system, and the skin.…”

Disseminated fatal mucormycosis in a relapsed acute lymphoblastic leukemic child

“…Delay in diagnosis of mucormycosis in immunocompromised individuals leads to life-threatening complications such as bowel wall perforation in GI mucormycosis, hard palate perforation in rhinocerebral form, and in extremely rare cases, thyroiditis in disseminated form. [10]…”