Pediatric Mucormycosis: A 10-Year Systematic Review of Reported Cases and Review of the Literature. (10th June 2019)

• Record Type: Journal Article
• Authors: Otto, William R; Pahud, Barbara A; Yin, Dwight E
• Is Part Of: Journal of the Pediatric Infectious Diseases Society. Volume 8:Number 4(2019)
• Page Start: 342
• Page End: 350
• Publication Date: 2019-06-10
• Subjects: mucormycosis -- outcome -- risk factors -- treatment -- zygomycosis; Communicable diseases in children -- Periodicals; Children -- Diseases -- Periodicals; 618.929
• DOI: 10.1093/jpids/piz007
• Languages: English
• ISSNs: 2048-7193

Abstract

Abstract: Mucormycosis is a severe infection that affects a variety of patients, including immunocompromised children and neonates. Given improved survival rates from advances in the treatment of malignancies, the population at risk for mucormycosis is increasing. We conducted a systematic review of cases of mucormycosis in children in the English-language literature reported between August 2008 and June 2017 and analyzed the clinical characteristics, diagnosis, management, and outcome of those infections. The most common underlying diagnoses included neutropenia (41%), hematologic malignancy (39%), prematurity (13%), and hematopoietic stem cell transplant (11%). Sinus disease (28%) and disseminated disease (24%) were the most common presentations. Rhizopus spp were the most common organisms isolated (22%). Amphotericin B remains the backbone of treatment and was prescribed in 86% of these cases. The resulting mortality rate remains high (32%). We provide here the results of a literature review of mucormycosis in children, including its epidemiology and clinical manifestations, and describe current advances in its diagnosis and treatment. Abstract : Mucormycosis is a life-threatening infection, particularly in immunocompromised children. We systematically reviewed and analyzed 226 cases of mucormycosis published in the past 10 years and compared risk factors, clinical presentation, diagnosis, management, and outcome with those described in previously published literature. Amphotericin B remains the mainstay medical therapy along with aggressive surgical debridement and effective immune recovery, but the resulting mortality rate remains high.