The diagnostic pitfalls of mucormycosis

Mauro, Margherita; Cascio, Giuliana Lo; Balter, Rita; Zaccaron, Ada; Bonetti, Elisa; Vitale, Virginia; Chinello, Matteo; Bortoli, Massimiliano De; Brazzarola, Paolo; Bruno, Costanza; Cesaro, Simone

doi:10.4084/mjhid.2020.079

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Other reliable techniques for diagnosis are PCR (polymerase chain reaction) 1 and, although less available, next-generation metagenomic sequencing techniques that can be performed on peripheral blood, cerebrospinal fluid, and bronchioalveolar lavage fluid 9 . Proper diagnosis is of utmost importance, as misdiagnosis or empirical treatment delays appropriate treatment with ineffective clinical outcomes 10 .…”

Section: Discussionmentioning

confidence: 99%

Disseminated mucormycosis in a child with acute lymphoblastic leukemia: a case report and autopsy findings

Teco-Cortés¹,

Arrecillas-Zamora²

2023

BMHIM

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Background: Mucormycosis is a rare infection caused by ubiquitous fungi of the Mucorales order that mainly affects immunocompromised patients. These fungi have an important tropism for blood vessels that allows them to spread rapidly and cause thromboembolic events. Case report: We present a case of an 8-year-old male patient diagnosed with acute lymphoblastic leukemia treated with chemotherapy. He presented icteric syndrome, hepato-splenomegaly, and data of intestinal obstruction. Although he underwent intestinal resection, he did not improve and died. The autopsy identified disseminated mucormycosis involving the brain, lungs, esophagus, small intestine, colon, and pancreas. Conclusions: Hematological neoplastic diseases and their treatment are important risk factors for developing infections by opportunistic microorganisms such as mucormycosis. Early diagnosis and adequate treatment are essential due to their intrinsic difficulty and the high mortality rate of these cases.

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Section: Discussionmentioning

confidence: 99%

Disseminated mucormycosis in a child with acute lymphoblastic leukemia: a case report and autopsy findings

Teco-Cortés¹,

Arrecillas-Zamora²

2023

BMHIM

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Antineoplastics/dexamethasone/rituximab

2021

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Clinical presentations, diagnosis, management, and outcomes of renal mucormycosis: An overview of case reports

et al. 2022

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BackgroundRenal mucormycosis (RM) is a rare presentation of invasive mucormycosis with a high mortality rate. There is no single systematic review of the literature that indicates the different clinical aspects of RM.MethodsA systematic search of PubMed/Medline was performed to collect individual case reports of RM in patients of all ages published between 2010 and April 2022.ResultsSeventy-one individual cases were detected through PubMed bibliographic database searches, with a final assessment performed on 60 patients with RM. India and Asia had the largest number of reported cases, with 30 (50%) and 42 (70%) reports, respectively. Also, 74 and 26% of the patients with a mean age of 33 years were male and female, respectively. RM showed 44% mortality rate in the analyzed cases. Immunosuppressive agent therapy followed by tissue transplantation (kidney and liver) and diabetes were the most remarkable risk factors in patients. Nevertheless, 22% of the patients were immunocompetent with no apparent underlying condition. COVID-19 positivity was detected in eight adult patients with an 87% mortality rate. The most common signs of infection were fever, flank pain, and oliguria; additionally, isolated RM was reported in 57% of the cases. In 55% of the patients, histopathologic examination alone was sufficient to diagnose RM, whereas molecular methods and culture were used in only 18 and 35% of patients, respectively. Surgery alone, surgery plus anti-infection therapy, and anti-infection therapy alone were used in 12, 60, and 13% of patients, respectively. Furthermore, 15% of the patients died before any treatment.ConclusionThe early diagnosis of RM is necessary. In this regard, the use of molecular-based diagnostic assays can help identify the fungus at the genus and species levels and use an appropriate treatment in the shortest possible amount of time. Because of the increase in antibiotic resistance in recent years, determining microbial susceptibility tests can lead to the better infection management. Additionally, withdrawal of immunosuppressant, appropriate surgical intervention, and antifungal therapy are the main factors associated with a successful outcome in RM.

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The diagnostic pitfalls of mucormycosis

Cited by 3 publications

References 16 publications

Disseminated mucormycosis in a child with acute lymphoblastic leukemia: a case report and autopsy findings

Disseminated mucormycosis in a child with acute lymphoblastic leukemia: a case report and autopsy findings

Antineoplastics/dexamethasone/rituximab

Clinical presentations, diagnosis, management, and outcomes of renal mucormycosis: An overview of case reports

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