毛霉菌病是一种新出现的疾病,主要影响免疫功能低下的患者;然而,在有免疫能力的个体中也有报道。儿科人群的研究有限,主要以案例研究或系列报道。本病例报告的目的是介绍起源于苏门答腊岛的小儿毛霉菌病,印度尼西亚。一名十三岁男童因面部坏死累及鼻部,被转介至三甲医院,口服,和左上颌区域,以及左眶周围水肿。没有记录已知的潜在条件。广泛的组织病理学发现证实了诊断,pauci-septate,在90°分枝的带状菌丝。患者由由耳朵组成的多学科小组管理,鼻子,喉咙,传染病,皮肤病学,手术,微生物学,和病理科。患者的管理包括坏死病变的清创和抗生素和抗真菌药(氟康唑)。由于不可用,患者未接受两性霉素B治疗。患者入院30天后死亡。这个案例突出了保持高度怀疑侵袭性毛霉菌病的重要性,即使在有免疫能力的儿童中,当出现症状和体征时,尤其是在资源有限的环境中。
Mucormycosis is an emerging disease that primarily affects immunocompromised patients; however, it has also been reported in immunocompetent individuals. Studies in the pediatric population are limited and reported mostly in
case studies or series. The aim of this
case report is to present a pediatric mucormycosis originated from Sumatra Island, Indonesia. A 13-year-old boy was referred to a tertiary hospital with facial necrosis involving the nasal, oral, and left maxillary areas, as well as left periorbital edema. No known underlying conditions were documented. The diagnosis was confirmed by histopathological findings of broad, pauci-septate, ribbon-like hyphae branching at 90°. The patient was managed by a multidisciplinary team consisting of the ear, nose, and throat, infectious diseases, dermatology, surgery, microbiology, and pathology departments. Management of the patient included debridement of the necrotic lesion and antibiotics and anti-fungal (fluconazole). Due to unavailability, the patient was not treated with amphotericin B. The patient died after 30 days of admission. This
case highlights the importance of maintaining a high suspicion of invasive mucormycosis, even in immunocompetent children, when symptoms and signs are present, especially in resource-limited settings.