Severe cutaneous zygomycosis: evaluation of treatment with high doses of liposomal amphotericin B in a one-year old child.

摘要

We report a case of severe cutaneous infection by Absidia corymbifera and Syncephahstrum race-mosum in a one-year old child treated successfully with surgical debridement and parenteral administration of liposomal amphotericin B. We underline the effectiveness of the multidisciplinary approach and the use of high doses of liposomal amphotericin B. Absidia corymbifera and Syncephalastrum racemosum, belonging to the class of zygomycetes, mucorales orders, are responsible for acute, necrotic fungal infections, characterized by angio-invasion, vascular thrombosis and tissue necrosis. Although healthy humans have a strong natural immunity to infection from zygomycetes, patients with underlying local or systemic predisposing factors can easier develop the disease and a high mortality is reported even when aggressive antifungal therapy and surgical debridement are used . The present report describes a case of cutaneous zygomycosis occurring in a pediatric patient affected by hyposplenia and previous pneumococcal purpura fulminans .