Related Experiment Videos
[Disseminated mucormycosis in pediatrics]
P Jouvet1, P Hubert, S Blanche
1Service de Réanimation Pédiatrique, Hôpital Necker-Enfants-Malades, Paris.
Insights
Hereditary lymphohistiocytosis in an infant led to severe complications including esophageal necrosis and mucormycosis. Despite antifungal treatment, the child succumbed to disseminated abscesses.
Area of Science:
- Pediatric Hematology Oncology
- Infectious Diseases
- Critical Care Medicine
Background:
- Hereditary lymphohistiocytosis (HLH) is a rare, life-threatening condition of immune dysregulation.
- Infants with HLH often present with prolonged fever, cytopenias, and organomegaly.
- Chemotherapy-induced aplasia can increase susceptibility to opportunistic infections.
Observation:
- A 14-month-old infant with HLH developed post-chemotherapy aplasia.
- Clinical manifestations included peritoneal and cutaneous necrosis, progressing to pleuropulmonary involvement.
- Fiberendoscopy revealed esophageal necrosis complicated by a pleural fistula.
Findings:
- The infant's condition deteriorated despite antifungal therapy.
- Post-mortem examination confirmed disseminated mucormycosis as the cause of death.
- This case highlights a rare but fatal complication of HLH in pediatric oncology.
Implications:
- Early recognition and aggressive management of opportunistic infections are crucial in HLH patients.
- Mucormycosis poses a significant threat in immunocompromised pediatric populations.
- Further research into HLH-associated infections and treatment strategies is warranted.
Abstract:
The case of a 14 month-old infant presenting with hereditary lymphohistiocytosis is reported. After several days of post-chemotherapy aplasia a peritoneal, cutaneous (blackish necrosis), then pleuropulmonary involvement occurred. Fiberendoscopy showed an esophageal necrosis responsible for a pleural fistula. The child died after a few weeks, despite antifungal treatment. Post mortem examination found disseminated abscesses related to mucormycosis. The 41 pediatric cases in the world-wide literature are recorded.