Sinonasal Mucormycosis in Immunocompromised Pediatric Patients

Abstract

Sinonasal mucormycosis in the immunocompromised pediatric population is an uncommon but potentially fatal disease. A high index of suspicion is of utmost importance to decrease its related morbidity and mortality.

A meta‐analysis of survival factors in rhino‐orbital‐cerebral mucormycosis—has anything changed in the past 20 years?

“…In total, 210 case reports were identified from the literature search and reviewed, of which 175 contained sufficient clinical data to be analysed. These were derived from a total of 140 papers (some papers contained multiple case reports) . Larger case series were usually excluded due to a lack of chronological data (refer to Figure for PRISMA flow diagram).…”

Imaging of Acute Invasive Fungal Rhinosinusitis in a Patient with Gorlin Syndrome and Acute Lymphocytic Leukemia

“…Hypoenhancement and near-normal T2 signal in invasive fungal disease due to microvascular invasion of hyphae and subsequent necrosis in the absence of an immune response sufficient to cause substantial mucosal edema, as seen in this case, are suggestive of AIFRS; this is distinct from the diffuse enhancement and T2 hyperintensity typically seen in other inflammatory diseases [12, 13]. A pattern of nasal cavity, orbital, ethmoid, and maxillary involvement is highly suggestive [14].…”

Recurrent Rhino-Ocular-Cerebral Mucormycosis in a Leukemic Child: A Case Report and Review of Pediatric Literature

“… 3 Four immunocompromized patients with nasal sinuses mucormycosis undergoing multiple aggressive debridement were described by Rassi et al ; in the postoperative course one child died of the disease, one developed persistent unilateral blindness, one was lost to follow-up and the last one was cured with no sequelae. 4 Other single-center pediatric cases have recently been described, including a seven-year-old girl with ALL and rhino-cerebral mucormycosis, two children with acute leukemia and intraoral mucormycosis and four children with ALL and cutaneous mucormycosis; all patients were successfully treated with amphotericin B and surgical debridement. 5-8 Further case reports describe a child with acute leukemia and isolated muscular mucormycosis, one with ALL and fatal gastrointestinal mucormycosis, a nine-year-old boy with ALL and isolated hepatic mucormycosis requiring surgical excision and combined liposomal amphotericin B and posaconazole therapy.…”