Isolated cutaneous mucormycosis in a pediatric renal transplant recipient
Corresponding Author
Mallory L. Downie
Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
Correspondence
Lisa A. Robinson, Mallory L. Downie, Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
Emails: [email protected]; [email protected]
Search for more papers by this authorMohammad Alghounaim
Division of Infectious Diseases, Departments of Pediatrics & Medical Microbiology, The Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
Search for more papers by this authorKristen M. Davidge
Division of Plastic & Reconstructive Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorYvonne Yau
Division of Microbiology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorThomas J. Walsh
Transplantation-Oncology Infectious Diseases Program, Weill Cornell University Medical Center, New York, NY, USA
Search for more papers by this authorElena Pope
Section of Dermatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorGino R. Somers
Division of Pathology, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorValerie Waters
Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorCorresponding Author
Lisa A. Robinson
Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
Correspondence
Lisa A. Robinson, Mallory L. Downie, Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
Emails: [email protected]; [email protected]
Search for more papers by this authorCorresponding Author
Mallory L. Downie
Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
Correspondence
Lisa A. Robinson, Mallory L. Downie, Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
Emails: [email protected]; [email protected]
Search for more papers by this authorMohammad Alghounaim
Division of Infectious Diseases, Departments of Pediatrics & Medical Microbiology, The Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
Search for more papers by this authorKristen M. Davidge
Division of Plastic & Reconstructive Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorYvonne Yau
Division of Microbiology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorThomas J. Walsh
Transplantation-Oncology Infectious Diseases Program, Weill Cornell University Medical Center, New York, NY, USA
Search for more papers by this authorElena Pope
Section of Dermatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorGino R. Somers
Division of Pathology, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorValerie Waters
Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
Search for more papers by this authorCorresponding Author
Lisa A. Robinson
Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
Correspondence
Lisa A. Robinson, Mallory L. Downie, Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
Emails: [email protected]; [email protected]
Search for more papers by this authorAbstract
Mucormycosis is a rare and potentially life-threatening infection, typically affecting immunocompromised hosts. We report a case of an adolescent boy who developed primary isolated cutaneous mucormycosis in the early period following kidney transplantation. Surgical excision was performed using intraoperative fungal staining to obtain clear margins, followed by topical and systemic antifungal therapy. A skin graft was then applied to the excised area with good healing, and the patient made a full recovery.
REFERENCES
- 1Shadur B, Trahair TN, O'Brien T, Russell SJ, Ziegler JB. Desensitisation to liposomal amphotericin B. J Allergy Clin Immunol Pract. 2017; 5: 181-183.
- 2Song Y, Qiao J, Giovanni G, et al. Mucormycosis in renal transplant recipients: review of 174 reported cases. BMC Infect Dis. 2017; 17: 283.
- 3Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis. 2012; 54(Suppl 1): S23-S34.
- 4Zaoutis TE, Roilides E, Chiou CC, et al. Zygomycosis in children: a systematic review and analysis of reported cases. Pediatr Infect Dis J. 2007; 26: 723-727.
- 5Spellberg B, Edwards J, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev. 2005; 18: 556-569.
- 6Lanternier F, Sun H-Y, Ribaud P, Singh N, Kontoyiannis DP, Lortholary O. Mucormycosis in organ and stem cell transplant recipients. Clin Infect Dis. 2012; 54: 1629-1636.
- 7Lionakis MS, Kontoyiannis DP. Glucocorticoids and invasive fungal infections. Lancet Lond Engl. 2003; 362: 1828-1838.
- 8Zimmermann N, Hagen MC, Schrager JJ, Hebbeler-Clark RS, Masineni S. Utility of frozen section analysis for fungal organisms in soft tissue wound debridement margin determination. Diagn Pathol. 2015; 10: 188.
- 9Walsh TJ, Gamaletsou MN, McGinnis MR, Hayden RT, Kontoyiannis DP. Early clinical and laboratory diagnosis of invasive pulmonary, extrapulmonary, and disseminated mucormycosis (zygomycosis). Clin Infect Dis. 2012; 54(Suppl 1): S55-S60.
- 10Ibrahim AS, Gebremariam T, Schwartz JA, Edwards JE, Spellberg B. Posaconazole mono- or combination therapy for treatment of murine zygomycosis. Antimicrob Agents Chemother. 2009; 53: 772-775.
- 11Marty FM, Ostrosky-Zeichner L, Cornely OA, et al. Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis. Lancet Infect Dis. 2016; 16: 828-837.
- 12Di Pentima MC, Chan S, Powell J, Napoli JA, Walter AW, Walsh TJ. Topical amphotericin B in combination with standard therapy for severe necrotizing skin and soft-tissue mucormycosis in an infant with bilineal leukemia: case report and review. J Pediatr Hematol Oncol. 2014; 36: e468-e470.
Citing Literature
