1. Paediatric cutaneous mucormycosis: A case report and review of the literature.
- Author
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Ziaka, Maria, Papakonstantinou, Eugenia, Vasileiou, Efi, Chorafa, Elisavet, Antachopoulos, Charalampos, and Roilides, Emmanuel
- Subjects
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PREMATURE infants , *MUCORMYCOSIS , *TYPE 1 diabetes , *MYCOSES , *TRAFFIC accidents , *LITERATURE reviews - Abstract
Background: Mucormycosis has emerged as an increasingly important fungal disease for immunocompromised children and neonates, with the cutaneous form being one of its most common presentations. Methods: We present a cutaneous mucormycosis case in a 10‐year‐old girl and analyse reports of single cases and case series of cutaneous mucormycosis in ≤16‐year‐old patients, recorded in PUBMED from 1953 to 2020, for epidemiology, risk factors, diagnostic and therapeutic procedures and outcome. Results: 113 cases were enrolled. Median age was 5 years (Interquartile Range [IQR] 10.9), without gender predominance. Underlying conditions were haematologic malignancies/disorders (25.7%), prematurity (23%), solid organ transplantation (3.5%), diabetes mellitus type 1 (4.4%), immunodeficiency and other diseases (14.2%), and no underlying conditions (29.2%). Inoculation occurred through major trauma (12.4%), including surgery and motor vehicle accidents, catheter sites (27.4%), dressings, patches and probes (11.5%), burns and farm‐related accidents (8.8%). Rhizopus spp. was most frequently isolated (43.4%), followed by Lichtheimia corymbifera (9.7%), Saksenaea vasiformis (8%), Mucor and Rhizomucor spp. (5.3% each), other species/combinations (7.2%) and unspecified isolates (21.2%). Surgery was combined with antifungals in 62.8%. Each was performed solely in 27.4% and 6.2%, respectively. Amphotericin B was used in 78% (alone in 55.8% and combined with other antifungals in 22.2%) of the cases. Overall mortality was 26.5%. In regression analysis, prematurity and haematologic malignancies/disorders were associated with increased mortality, whereas combination of antifungals and surgery with improved survival. Conclusion: Cutaneous mucormycosis mainly affects premature infants and children with haematologic malignancies/disorders. Outcome is improved when active antifungal therapy and surgery are combined. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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