OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press4410.17650/1818-8346-2013-8-1-52-58HEMATOLOGIC MALIGNANCIES: DIAGNOSIS, TREATMENT, SUPPORTIVE CAREГЕМОБЛАСТОЗЫ: ДИАГНОСТИКА, ЛЕЧЕНИЕ, СОПРОВОДИТЕЛЬНАЯ ТЕРАПИЯSuccessful treatment of pulmonary mucormycosis in a child with aplastic anemiaСлучай успешного лечения мукормикоза легких у ребенка с апластической анемиейNikitinaYe. A.НикитинаЕ. А.
Russian Federation
leukem.dgb1@gmail.comKlimkoN. N.КлимкоН. Н.
Russian Federation
KolbinA. S.КолбинА. С.
Russian Federation

медицинский факультет

BoychenkoE. G.БойченкоЭ. Г.
Russian Federation
GarbuzovaI. A.ГарбузоваИ. А.
Russian Federation
GolubevaM. V.ГолубеваМ. В.
Russian Federation
BogomolovaT. S.БогомоловаТ. С.
Russian Federation
Children Municipal Hospital № 1Детская городская больница № 1I.I. Mechnikov North-Western State Medical University, Ministry of Health of RussiaГБОУ ВПО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииSaint Petersburg State UniversityФГБОУ ВПО «Санкт-Петербургский государственный университет»2202201381525822072014220720142013https://oncohematology.abvpress.ru/ongm/article/view/44

Mucormycosis (zygomycosis) is a frequently fatal fungal infection in immunocompromized patients. We describe a case of a successfull treatment of pulmonary mucormycosis in 11-year-child with a very severe aplastic anemia. The diagnosis of invasive mycosis has been proved according to EORTC 2008 criteria. Computed tomography showed bilobar right-sided pulmonary infiltration. Lichtheimia corymbifera cultured from BAL. The child achieved complete clinical, laboratory and instrumental response on long-term amphotericin B lipid-formulated therapy combined with posaconazole.

Мукормикоз (зигомикоз) характеризуется высокой летальностью у иммунокомпрометированных больных. Представлен клинический случай успешного лечения мукормикоза у 11-летнего ребенка со сверхтяжелой формой идиопатической апластической анемии. Диагноз инвазивного микоза был установлен на основании критериев EORTC 2008. При компьютерной томографии определена субтотальная инфильтрация правого легкого. При исследовании бронхоальвеолярного лаважа выделили Lichtheimia corymbifera. В результате длительной комбинированной антифунгальной терапии липидным комплексом амфотерицина B и позаконазолом удалось добиться полного купирования клинико-лабораторных и инструментальных проявлений мукормикоза и продолжить успешное лечение апластической анемии.

mucormycosisaplastic anemiaamphotericin Bposaconazolechildrenмукормикозапластическая анемияамфотерицин Bпозаконазолдети1. Климко Н.Н. Микозы: диагностика и лечение. Руководство для врачей. 2-е изд. перераб. и доп. М.: Премьер МТ, 2008. 336 с.Климко Н.Н. Микозы: диагностика и лечение. Руководство для врачей. 2-е изд. перераб. и доп. М.: Премьер МТ, 2008. 336 с.2. De Pauw B., Walsh T.J., Donnelly J.P. et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 2008;46:1813–21.De Pauw B., Walsh T.J., Donnelly J.P. et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 2008;46:1813–21.3. Климко Н.Н., Васильева Н.В., Елинов Н.П. и др. Перечень основных методов и критериев диагностики микозов. СПб., 2001. 24 с.Климко Н.Н., Васильева Н.В., Елинов Н.П. и др. Перечень основных методов и критериев диагностики микозов. СПб., 2001. 24 с.4. Gonzalez C.E., Rinaldi M.G., Sugar A.M. Zygomycosis. Infect Dis Clin North Am 2002;16(4):895–914.Gonzalez C.E., Rinaldi M.G., Sugar A.M. Zygomycosis. Infect Dis Clin North Am 2002;16(4):895–914.5. Kontoyiannis D.P., Lionakis M.S., Lewis R.E. et al. Zygomycosis in a tertiarycare cancer center in the era of Aspergillusactive antifungal therapy: A case-control observational study of 27 recent cases. J Infect Dis 2005;191:1350–60.Kontoyiannis D.P., Lionakis M.S., Lewis R.E. et al. Zygomycosis in a tertiarycare cancer center in the era of Aspergillusactive antifungal therapy: A case-control observational study of 27 recent cases. J Infect Dis 2005;191:1350–60.6. Marr K.A., Carter R.A., Crippa F. et al. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 2002;34:909–17.Marr K.A., Carter R.A., Crippa F. et al. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 2002;34:909–17.7. Harada M., Manabe T., Yamashita K. et al. Pulmonary mucormycosis with fatal massive hemoptysis. Acta Pathol Jpn 1992;42:49–55.Harada M., Manabe T., Yamashita K. et al. Pulmonary mucormycosis with fatal massive hemoptysis. Acta Pathol Jpn 1992;42:49–55.8. Tedder M., Spratt J.A., Anstadt M.P. et al. Pulmonary mucormycosis: Results of medical and surgical therapy. Ann Thorac Surg 1994;57:1044–50.Tedder M., Spratt J.A., Anstadt M.P. et al. Pulmonary mucormycosis: Results of medical and surgical therapy. Ann Thorac Surg 1994;57:1044–50.9. Gleissner B., Schilling A., Anagnostopolous I. et al. Improved outcome of zygomycosis in patients with hematological diseases? Leukemia Lymphoma 2004;45:1351–60.Gleissner B., Schilling A., Anagnostopolous I. et al. Improved outcome of zygomycosis in patients with hematological diseases? Leukemia Lymphoma 2004;45:1351–60.10. Tedder M., Spratt J.A., Anstadt M.P. et al. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg 1994;57:1044–50.Tedder M., Spratt J.A., Anstadt M.P. et al. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg 1994;57:1044–50.11. Spellberg B., Walsh T.J., Kontoyiannis D.P. et al. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis 2009;48(12):1743–51.Spellberg B., Walsh T.J., Kontoyiannis D.P. et al. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis 2009;48(12):1743–51.12. Van Burik J-A., Hare R.S., Solomon H.F. et al. Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases. Clin Infect Dis 2006;42:e61–5.Van Burik J-A., Hare R.S., Solomon H.F. et al. Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases. Clin Infect Dis 2006;42:e61–5.13. Spellberg B., Ibrahim A., Roilides E. et al. Combination therapy for mucormycosis: why, what, and how? Clin Infect Dis 2012;54 Suppl 1:S73.Spellberg B., Ibrahim A., Roilides E. et al. Combination therapy for mucormycosis: why, what, and how? Clin Infect Dis 2012;54 Suppl 1:S73.14. Zaoutis T.E., Roilides E., Chiou C.C. et al. Zygomycosis in children: a review and analysis of reported cases. Pediatr Infect Dis J 2007;26:723–7.Zaoutis T.E., Roilides E., Chiou C.C. et al. Zygomycosis in children: a review and analysis of reported cases. Pediatr Infect Dis J 2007;26:723–7.15. Roden M.M., Zaoutis T.E., Buchanan W.L. et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis 2005;41:634–53.Roden M.M., Zaoutis T.E., Buchanan W.L. et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis 2005;41:634–53.16. Roilides E., Zaoutis T.E. and Walsh T.J. Invasive zygomycosis in neonates and children. Clin Microbiol Infect 2009;15:50–4. doi: 10.1111/j.1469-0691.2009.02981.xRoilides E., Zaoutis T.E. and Walsh T.J. Invasive zygomycosis in neonates and children. Clin Microbiol Infect 2009;15:50–4. doi: 10.1111/j.1469-0691.2009.02981.x17. Garner D., Machin K. Investigation and management of an outbreak of mucormycosis in a paediatric oncology unit. J Hosp Infect 2008;70(1):53–9.Garner D., Machin K. Investigation and management of an outbreak of mucormycosis in a paediatric oncology unit. J Hosp Infect 2008;70(1):53–9.18. Sun H.Y., Aguado J.M., Bonatti H. et al. Zygomycosis Transplant Study Group. Pulmonary zygomycosis in solid organ transplant recipients in the currentera. Am J Transplant 2009;9(9): 2166–71.Sun H.Y., Aguado J.M., Bonatti H. et al. Zygomycosis Transplant Study Group. Pulmonary zygomycosis in solid organ transplant recipients in the currentera. Am J Transplant 2009;9(9): 2166–71.