Necrotizing fasciitis caused by Mucor indicus in a pediatric bone marrow transplant recipient

• Type of Material: Article
• Authors: Deborah Bloch, Emory University; Mark Gonzalez, Emory University; Ann Haight, Emory University; Carlos Abramowsky, Emory University; Inci Yildirim, Emory University
• Language: English
• Date: 2018-12-01
• Publisher: Wiley
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 Wiley Periodicals, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1111/petr.13294
• Title of Journal or Parent Work: Pediatric Transplantation
• Volume: 22
• Issue: 8
• Start Page: e13294
• End Page: e13294
• Keywords: Life Sciences & Biomedicine; necrotizing fasciitis; Transplantation; PERSPECTIVES; UPDATE; MUCORMYCOSIS; ZYGOMYCOSIS; bone marrow transplantation; Mucor indicus; Science & Technology; INFECTIOUS-DISEASES SOCIETY; Pediatrics; PATIENT; Mucorales; CHILDREN
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Necrotizing fasciitis is a life-threatening, rapidly progressing infection of fascia and subcutaneous cellular tissue typically caused by mixed aerobic and anaerobic bacteria. We present a case report of an immunocompromised 4-year-old female with necrotizing fasciitis from a rare fungal organism, Mucor indicus. The patient underwent multiple debridements and was treated for 10 months, first on liposomal amphotericin B (2 months) then posaconazole (8 months). Mucor indicus is a rarely described pathogen with only nine other cases described. Identification of this organism remains a challenge, and the need for further understanding of risk factors and organism susceptibility testing to help guide treatment is crucial.