Yu Nan, Ye Sheng, Yang Zihao, Chen Zhenjie, Zhang Chenmei
Department of PICU, National Clinical Research Center for Child Health, the Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
J Pediatr Hematol Oncol. 2023 Mar 1;45(2):e266-e271. doi: 10.1097/MPH.0000000000002577. Epub 2022 Oct 24.
We described a 14-year-old girl with acute lymphoblastic leukemia who developed disseminated mucormycosis during induction therapy. Disseminated Cunninghamella elegans infection was confirmed by histopathology, microbiological culture, and metagenomic next-generation sequencing analysis of skin tissue, blood, and cerebrospinal fluid. Subsequently, the patient received a combination of liposomal amphotericin B, posaconazole, and caspofungin for antifungal treatment, but eventually died because of severe fungal pneumonia, respiratory failure, and septic shock. Moreover, case reports of pulmonary mucormycosis in children published since 1959 were reviewed. In summary, metagenomic next-generation sequencing is an effective diagnostic method for Cunninghamella with high speed and sensitivity.
我们描述了一名14岁患急性淋巴细胞白血病的女孩，她在诱导治疗期间发生了播散性毛霉病。通过组织病理学、微生物培养以及对皮肤组织、血液和脑脊液的宏基因组下一代测序分析，确诊为播散性雅致小克银汉霉感染。随后，该患者接受了脂质体两性霉素B、泊沙康唑和卡泊芬净联合抗真菌治疗，但最终因严重真菌性肺炎、呼吸衰竭和感染性休克死亡。此外，还回顾了自1959年以来发表的儿童肺毛霉病病例报告。总之，宏基因组下一代测序是一种针对小克银汉霉的高效、灵敏的诊断方法。
