Paediatric mucormycosis: a retrospective review of manifestations, diagnosis and treatment at a major tertiary paediatric hospital

Vollständiger Abstract

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Background: Cutaneous mucormycosis is a rare yet severe fungal infection that affects immunocompromised paediatric patients. Although prompt diagnosis is essential, excisional tissue biopsy often necessitates general anaesthesia in the paediatric population, which presents risks in the unwell and immunocompromised patient. This study assessed the diagnostic value of the biopsy and associated outcomes in paediatric cutaneous mucormycosis. Methods: We retrospectively analysed 38 paediatric patients (aged 0–18 years) with suspected or confirmed mucormycosis at a tertiary hospital. Data on demographics, underlying conditions, clinical presentation, diagnostics, treatments and outcomes were collected. Results: Out of the 38 patients included, mucormycosis was confirmed in 10 cases. Most patients were immunocompromised, with 60.5 per cent having haematological malignancies and 47.4 per cent experiencing neutropenia. Cutaneous involvement was the exclusive manifestation in 90 per cent of confirmed cases. Biopsies were conducted in 73.7 per cent of patients; however, only 28.6 per cent yielded positive results. General anaesthesia is frequently required. Antifungal therapy was initiated in 89.5 per cent of cases, whereas surgical debridement was only required in 28.9 per cent of cases. The mortality rate was 20 per cent in confirmed cases and 39.3 per cent in suspected cases. Conclusion: Excisional biopsy plays a diagnostic role in suspected paediatric cutaneous mucormycosis but is associated with low yield and procedural risks. The development of improved non-invasive diagnostic alternatives may mitigate unnecessary procedural risks in this patient population.