Pediatric Mucormycosis: A 10-Year Systematic Review of Reported Cases and Review of the Literature

J Pediatric Infect Dis Soc. 2019 Sep 25;8(4):342-350. doi: 10.1093/jpids/piz007.

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.

Keywords: mucormycosis; outcome; risk factors; treatment; zygomycosis.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Child
  • Child, Preschool
  • Databases, Factual
  • Female
  • Hematologic Neoplasms
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mucormycosis / diagnosis*
  • Mucormycosis / drug therapy*
  • Mucormycosis / epidemiology*
  • Mucormycosis / microbiology
  • Neutropenia / drug therapy
  • Paranasal Sinus Diseases / microbiology
  • Rhizopus / isolation & purification
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Amphotericin B