Central Line-Associated Mucor velutinosus Bloodstream Infection in an Immunocompetent Pediatric Patient

Area of Science:

• Mycology
• Infectious Diseases
• Pediatrics

Background:

• Mucor velutinosus is a fungus rarely implicated in human infections.
• Central venous catheters, such as Broviac catheters, are potential sources of fungal bloodstream infections in immunocompromised patients.
• Pediatric patients with intestinal failure often require long-term central venous access and parenteral nutrition, increasing infection risk.

Observation:

• A 6-year-old boy with intestinal failure experienced a bloodstream infection and wound infection at the Broviac catheter insertion site.
• Microscopic examination revealed characteristic fungal elements, including wide nonseptate hyphae, sporangiophores, columella, and chlamydospores.
• Identification was confirmed as Mucor velutinosus via mass spectrometry and genomic sequencing.

Findings:

• The patient presented with a bloodstream infection caused by Mucor velutinosus, a rare pathogen in this context.
• This represents the first documented case of Mucor velutinosus bloodstream infection in a pediatric patient without a cancer diagnosis.
• Successful treatment involved intravenous amphotericin B and removal of the infected central venous catheter.

Implications:

• Highlights the potential for Mucor velutinosus to cause serious infections in vulnerable pediatric populations.
• Emphasizes the importance of considering rare fungal pathogens in bloodstream infections, especially in patients with central lines.
• Underscores the need for prompt diagnosis and appropriate antifungal therapy, alongside device removal, for successful management.