Mucormycosis in children with cancer and hematopoietic cell transplant-A single center cohort study.

Autor: Marón GA; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America.; Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America., Inagaki K; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America., Rodriguez A; Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America., Knapp KM; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America.; Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America., Hayden RT; Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America., Adderson EE; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America.; Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Feb 09; Vol. 19 (2), pp. e0297590. Date of Electronic Publication: 2024 Feb 09 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0297590
Abstrakt: Although mucormycosis is an important cause of morbidity and mortality in children with cancer, our understanding of the typical characteristics of these infections is incomplete. We reviewed all cases of mucormycosis diagnosed at a single pediatric cancer center over 5 decades to identify the clinical features of mucormycosis in pediatric oncology patients and to identify risk factors for mortality. There were 44 cases of mucormycosis diagnosed between 1970-2019. Most patients (89%) had hematological malignancies and a history of prolonged and severe neutropenia (91%). In this series, hyperglycemia and exposure to corticosteroids were common. Pulmonary (36%) and disseminated infections (32%) were most common; rhino-orbital-cerebral infections were relatively infrequent (11%). Rhizopus spp. was the most common etiological agent (40%) followed by Mucor spp. (31%), and Cunninghamella spp. (19%). Overall mortality was 44% and 51% and attributable mortality was 39% and 41% at the end of antifungal therapy and end of follow up, respectively. Attributable mortality fell to 18% in 2010-2019, from 58-60% in previous decades; adjunctive surgery was associated with decreased mortality. Mortality remains unacceptably high despite aggressive antifungal therapy and adjunctive surgery, suggesting novel therapeutic strategies are needed.
Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: R.H. reports receiving consultant fees from MiraVista and Abbott Laboratories and G.M. is the recipient of research funding from Astellas Pharma Inc. and SymBio Pharmaceuticals. No other authors have competing interests.
(Copyright: © 2024 Marón et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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