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Intraabdominal mass as presentation of colonic mucormycosis in a child with acute lymphoblastic leukemia
Wen-Ya Lin1, Te-Kau Chang, Chia-Man Chou
1Department of Pediatrics, Taichung Veterans General Hospital, Chung Shan Medical University, Taichung, Taiwan.
Insights
Gastrointestinal mucormycosis is a rare condition, especially presenting as an abdominal mass in children with acute lymphoblastic leukemia. This case highlights a fatal outcome despite prompt surgical and antifungal treatment.
Area of Science:
- Mycology
- Pediatric Oncology
- Gastroenterology
Background:
- Gastrointestinal mucormycosis is a rare invasive fungal infection.
- It is associated with high mortality, particularly in immunocompromised patients.
- Clinical presentation as an abdominal mass is exceptionally uncommon.
Observation:
- A child with acute lymphoblastic leukemia and neutropenic fever developed increasing abdominal pain and distension.
- Symptoms progressed to peritonitis and a palpable abdominal mass.
- Imaging revealed ascending colon perforation with abscess formation.
Findings:
- Histologic examination and ascitic fluid culture confirmed colonic mucormycosis.
- The patient underwent right hemicolectomy.
- Intravenous liposomal amphotericin B was initiated post-operatively.
Implications:
- This case underscores the rare presentation of gastrointestinal mucormycosis as an abdominal mass in pediatric leukemia.
- It highlights the aggressive nature of the disease and the challenges in treatment.
- Early recognition and aggressive management are crucial, though outcomes remain poor.
Abstract:
Gastrointestinal mucormycosis with clinical presentation as an abdominal mass has been rarely reported in the current literature. In this observation, We report an unusual case of a child with acute lymphoblastic leukemia and neutropenic fever. During hospitalization, increasing abdominal pain and distension occurred, and initially treatments with broad-spectrum antibiotics were administered. However, the symptoms/signs progressed with the development of peritonitis and a palpated mass over the right lower quarter of the abdomen. Imaging studies showed ascending colon perforation with abscess formation. Right hemicolectomy was performed and colonic mucormycosis was confirmed on histologic examination and ascitic fluid culture. Immediately, intravenous liposomal amphotericin B was administered but the clinical condition rapidly deteriorated and the patient expired despite treatment.
