Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2020

Open Access 01-12-2020 | Orbitotomy | Case report

Orbital mucormycosis in immunocompetent children; review of risk factors, diagnosis, and treatment approach

Authors: Ali Amanati, Hamide Barzegar, Gholamreza Pouladfar, Anahita Sanaei Dashti, Mohamad Bagher Abtahi, Bijan Khademi, Mohammad Javad Ashraf, Parisa Badiee, Seyedeh Sedigheh Hamzavi, Ali Kashkooe

Published in: BMC Infectious Diseases | Issue 1/2020

Login to get access

Abstract

Background

Orbital mucormycosis is a rare but potentially severe and troublesome invasive fungal infection that could be occurred even in healthy individuals. The initial clinical presentation is similar to bacterial pre-septal or septal cellulitis, especially in early stages.

Case presentation

Herein, we describe the successful management of a series of five cases presenting with orbital mucormycosis in previously healthy children.

Conclusions

Orbital mucormycosis is extremely rare in healthy children and maybe life-threatening when diagnosis delayed given a similar clinical presentation with bacterial septal cellulitis. Intravenous antifungal therapy with amphotericin B and timely surgical drainage is live-saving.
Literature
1.
Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis. 2012;54(suppl_1):S23–34.PubMedCrossRef
2.
Dolatabadi S, Ahmadi B, Rezaei-Matehkolaei A, Zarrinfar H, Skiada A, Mirhendi H, et al. Mucormycosis in Iran: a six-year retrospective experience. J Mycol Med. 2018;28(2):269–73.PubMedCrossRef
3.
Vaezi A, Moazeni M, Rahimi MT, de Hoog S, Badali H. Mucormycosis in Iran: a systematic review. Mycoses. 2016;59(7):402–15.PubMedCrossRef
4.
Badiee P, Arastefar A, Jafarian H. Comparison of histopathological analysis, culture and polymerase chain reaction assays to detect mucormycosis in biopsy and blood specimens. Iran J Microbiol. 2013;5(4):406.PubMedPubMedCentral
5.
Bonifaz A, Tirado-Sánchez A, Calderón L, Romero-Cabello R, Kassack J, Ponce RM, et al. Mucormycosis in children: a study of 22 cases in a Mexican hospital. Mycoses. 2014;57:79–84.PubMedCrossRef
6.
Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B–based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis. 2008;47(4):503–9.PubMedCrossRef
7.
Scott E. Olitsky JDM. Abnormalities of Pupil and Iris,. In: Robert M, Kliegman JSG, editor. Nelson textbook of pediatrics 21st edition. Philadelphia: Elsevier; 2019. p. 3351.
8.
Badiee P, Jafarpour Z, Alborzi A, Haddadi P, Rasuli M, Kalani M. Orbital mucormycosis in an immunocompetent individual. Iran J Microbiol. 2012;4(4):210.PubMedPubMedCentral
9.
10.
Ziakas PD, Adraktas P, Ntountas J, Skarpidi E, Filippi V, Kechagias D, et al. Isolated orbital mucormycosis: a rare presentation ending in a fatal outcome. Int J Infect Dis. 2009;13(1):112–4.PubMedCrossRef
11.
Guevara JKH. Isolated orbital mucormycosis in an immunocompetent adolescent. Med Stud Res J. 2014;3:55–9.
12.
Badiee P, Gandomi B, Sabz G, Khodami B, Choopanizadeh M, Jafarian H. Evaluation of nested PCR in diagnosis of fungal rhinosinusitis. Iran J Microbiol. 2015;7(1):62.PubMedPubMedCentral
13.
Bethge W, Schmalzing M, Stuhler G, Schumacher U, Krober S, Horger M, et al. Mucormycoses in patients with hematologic malignancies: an emerging fungal infection. Haematologica. 2005;90(Suppl):ECR22–ECR.PubMed
14.
Enoch DA, Yang H, Aliyu SH, Micallef C. The changing epidemiology of invasive fungal infections. Human Fungal Pathogen Identification: Springer; 2017. p. 17–65.
15.
Pana ZD, Seidel D, Skiada A, Groll AH, Petrikkos G, Cornely OA, et al. Invasive mucormycosis in children: an epidemiologic study in European and non-European countries based on two registries. BMC Infect Dis. 2016;16(1):667.PubMedPubMedCentralCrossRef
16.
Elinav H, Zimhony O, Cohen M, Marcovich A, Benenson S. Rhinocerebral mucormycosis in patients without predisposing medical conditions: a review of the literature. Clin Microbiol Infect. 2009;15(7):693–7.PubMedCrossRef
17.
Lanternier F, Dannaoui E, Morizot G, Elie C, Garcia-Hermoso D, Huerre M, et al. A global analysis of mucormycosis in France: the RetroZygo Study (2005–2007). Clin Infect Dis. 2012;54(suppl_1):S35–43.PubMedCrossRef
18.
Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41(5):634–53.PubMedCrossRef
19.
Mignogna MD, Fortuna G, Leuci S, Adamo D, Ruoppo E, Siano M, et al. Mucormycosis in immunocompetent patients: a case-series of patients with maxillary sinus involvement and a critical review of the literature. Int J Infect Dis. 2011;15(8):e533–e40.PubMedCrossRef
20.
21.
22.
Habroosh FA, Eatamadi H, Mohamed RM. Concomitant orbital aspergillosis and mucormycosis in a 17 months old immunocompetent child. Saudi J Ophthalmol. 2017;31(3):193–5.PubMedPubMedCentralCrossRef
23.
Słowik M, Biernat MM, Urbaniak-Kujda D, Kapelko-Słowik K, Misiuk-Hojło M. Mycotic infections of the eye. Adv Clin Exp Med. 2015;24(6):1113–7.PubMedCrossRef
24.
Prabhu S, Alqahtani M, Al Shehabi M. A fatal case of rhinocerebral mucormycosis of the jaw after dental extractions and review of literature. J Infect Public Health. 2018;11(3):301–3.PubMedCrossRef
25.
26.
27.
Xia Z-K, Wang W-L, Yang R-Y. Slowly progressive cutaneous, rhinofacial, and pulmonary mucormycosis caused by Mucor irregularis in an immunocompetent woman. Clin Infect Dis. 2013;56(7):993–5.PubMedCrossRef
28.
Radner AB, Witt MD, Edwards JE Jr. Acute invasive rhinocerebral zygomycosis in an otherwise healthy patient: case report and review. Clin Infect Dis. 1995;20(1):163–6.PubMedCrossRef
29.
Zapico ADV, Suarez AR, Encinas PM, Angulo CM, Pozuelo EC. Mucormycosis of the sphenoid sinus in an otherwise healthy patient. Case report and literature review. J Laryngol Otol. 1996;110(5):471–3.CrossRef
30.
Baum JL. Rhino-orbital Mucormycosis: occurring in an otherwise apparently healthy individual. Am J Ophthalmol. 1967;63(2):335–9.PubMedCrossRef
31.
Blodi FC, Hannah FT, Wadsworth JA. Lethal orbitocerebral phycomycosis in otherwise healthy children. Am J Ophthalmol. 1969;67(5):698–705.PubMedCrossRef
32.
Swain S, Sahu M, Banerjee A. Non-sinonasal isolated facio-orbital mucormycosis–a case report. J Mycol Med. 2018;28(3):538–41.PubMedCrossRef
33.
Green WH, Goldberg HI, Wohl GT. Mucormycosis infection of the craniofacial structures. Am J Roentgenol. 1967;101(4):802–6.CrossRef
34.
Dooley DP, Hollsten DA, Grimes SR, Moss JJ. Indolent orbital apex syndrome caused by occult mucormycosis. J Clin Neuro Ophthalmol. 1992;12(4):245–9.
35.
36.
Kermani W, Bouttay R, Belcadhi M, Zaghouani H, Ali MB, Abdelkéfi M. ENT mucormycosis. Report of 4 cases. Eur Ann Otorhinolaryngol Head Neck Dis. 2016;133(2):83–6.PubMedCrossRef
37.
Farooq AV, Patel RM, Lin AY, Setabutr P, Sartori J, Aakalu VK. Fungal orbital cellulitis: presenting features, management and outcomes at a referral center. Orbit. 2015;34(3):152–9.PubMedPubMedCentralCrossRef
38.
Tissot F, Agrawal S, Pagano L, Petrikkos G, Groll AH, Skiada A, et al. ECIL-6 guidelines for the treatment of invasive candidiasis, aspergillosis and mucormycosis in leukemia and hematopoietic stem cell transplant patients. Haematologica. 2017;102(3):433–44.PubMedPubMedCentralCrossRef
39.
Sen ZS, Kara TT, Keskin S, Ozen G, Ornek F, Alioglu B. Preseptal and orbital cellulitis in childhood: the experience of Ankara training and research hospital. J Pediatr Res. 2019;1:64.
40.
Santos JC, Pinto S, Ferreira S, Maia C, Alves S, da Silva V. Pediatric preseptal and orbital cellulitis: a 10-year experience. Int J Pediatr Otorhinolaryngol. 2019;120:82–8.PubMedCrossRef
41.
Rahbar R, Robson CD, Petersen RA, DiCanzio J, Rosbe KW, McGill TJ, et al. Management of orbital subperiosteal abscess in children. Arch Otolaryngol Head Neck Surg. 2001;127(3):281–6.PubMedCrossRef
Metadata
Title
Orbital mucormycosis in immunocompetent children; review of risk factors, diagnosis, and treatment approach
Authors
Ali Amanati
Hamide Barzegar
Gholamreza Pouladfar
Anahita Sanaei Dashti
Mohamad Bagher Abtahi
Bijan Khademi
Mohammad Javad Ashraf
Parisa Badiee
Seyedeh Sedigheh Hamzavi
Ali Kashkooe
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2020
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-020-05460-2

Other articles of this Issue 1/2020

BMC Infectious Diseases 1/2020 Go to the issue

Research article

Spatio-temporal impact of self-financed rotavirus vaccination on rotavirus and acute gastroenteritis hospitalisations in the Valencia region, Spain

Research article

Intestinal parasites co-infection among tuberculosis patients in Ethiopia: a systematic review and meta-analysis

Correction

Correction to: Estimating the nationwide transmission risk of measles in US schools and impacts of vaccination and supplemental infection control strategies

Research article

Evaluation of TaqMan Array card (TAC) for the detection of 28 respiratory pathogens

Research article

Prevalence and recurrence of bacteraemia in hospitalised people who inject drugs – a single Centre retrospective cohort study in Denmark

Research article

Value of pyrazinamide for composition of new treatment regimens for multidrug-resistant Mycobacterium tuberculosis in China
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits