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CASE REPORT article

Front. Pediatr.
Sec. Pediatric Hematology and Hematological Malignancies
Volume 12 - 2024 | doi: 10.3389/fped.2024.1453059

Very Severe Aplastic Anemia in a Child with Pulmonary Mucormycosis: A Case Report

Provisionally accepted
Minchun Huang Minchun Huang 1,2Nanchuan Jiang Nanchuan Jiang 3Yahui Ren Yahui Ren 2Yun Peng Yun Peng 2Xiaoyan WU Xiaoyan WU 2*
  • 1 Huazhong University of Science and Technology, Wuhan, China
  • 2 Department of Pediatrics, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 3 Department of Radiology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China

The final, formatted version of the article will be published soon.

    Aplastic anemia (AA), is a rare but potentially life-threatening disease characterized by pancytopenia and a hypocellular bone marrow. Pulmonary mucormycosis (PM) is a rare but lifethreatening fungal infection observed in immunocompromised patients, particularly those with neutropenia and those using corticosteroids, with a high mortality rate from 40 to 80%. However, PM diagnosis and treatment remain challenging. This study reports a case of very severe aplastic anemia (VSAA) in a male child with PM. The innovation of this article lies in the following aspects: the patient exhibited typical clinical manifestations, the reverse halo sign (RHS) on chest computed tomography (CT), and a positive metagenomic next-generation sequencing (mNGS) analysis; despite aggressive anti-infective treatment and left lower lobectomy, he experienced a poor clinical outcome. Reflecting on cases with poor prognosis can indeed offer valuable insights and opportunities for learning. This study underlines the diagnostic challenges in mucormycosis, which should be considered in persistent fever that is unresponsive to standard antibiotic and antifungal therapies, and conduct a comprehensive examination to achieve early detection, diagnosis and treatment. It was concluded that, in addition to antifungal treatment, early surgery is essential for treating mucormycosis.

    Keywords: Pulmonary mucormycosis, Left lower lobectomy, metagenomic next-generation sequencing, Reverse halo sign, very severe aplastic anemia pulmonary mucormycosis, Very severe aplastic anemia

    Received: 22 Jun 2024; Accepted: 30 Aug 2024.

    Copyright: © 2024 Huang, Jiang, Ren, Peng and WU. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xiaoyan WU, Department of Pediatrics, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.