From the Day Hospitalization Department, Infectious Diseases Unit, Hemato-Oncology Department, Intensive Care Unit, Schneider Children's Medical Center of Israel, Petah Tikva.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.
Pediatr Infect Dis J. 2020 Aug;39(8):718-724. doi: 10.1097/INF.0000000000002671.
Mucormycosis is a rare but emerging life-threatening fungal disease with limited treatment options. Isavuconazole is a new triazole that has shown efficacy in adults for primary and salvage treatment of mucormycosis. However, data in children are scarce.
The demographic and clinical data of pediatric patients with proven mucormycosis who were treated with isavuconazole in 2015 to 2019 at 2 centers were collected.
Four children of median age 10.5 years (range 7-14) met the study criteria. Three had underlying hematologic malignancies, and 1 had sustained major trauma. Isavuconazole was used as salvage therapy in all: in 3 patients for refractory disease, and in 1 after intolerance to another antifungal drug. Isavuconazole was administered alone or combined with other antifungal agents. Following treatment and surgical intervention, complete clinical, radiologic and mycologic responses were documented in all patients. A literature review identified 8 children with mucormycosis who were successfully treated with isavuconazole, as salvage therapy in the majority.
Our limited experience supports the use of isavuconazole as salvage therapy in pediatric mucormycosis.
毛霉病是一种罕见但正在出现的危及生命的真菌感染，治疗选择有限。伊曲康唑是一种新型三唑类药物，已证明对成人原发性和挽救性毛霉病治疗有效。然而，儿童的数据很少。
收集了 2015 年至 2019 年在 2 个中心接受伊曲康唑治疗的确诊为毛霉病的儿科患者的人口统计学和临床数据。
4 名中位年龄为 10.5 岁（范围为 7-14 岁）的儿童符合研究标准。其中 3 例患有血液系统恶性肿瘤，1 例患有持续性严重创伤。所有患者均使用伊曲康唑进行挽救性治疗：3 例为耐药性疾病，1 例为对另一种抗真菌药物不耐受。伊曲康唑单独或与其他抗真菌药物联合使用。在治疗和手术干预后，所有患者均获得了完全的临床、放射学和真菌学反应。文献复习发现 8 例毛霉病患儿成功接受伊曲康唑治疗，大多数为挽救性治疗。
我们的有限经验支持伊曲康唑作为儿科毛霉病挽救性治疗的应用。
