Combination of invasive aspergillosis and mucormycosis in children: a case report and the results of a multicenter study

Objective. To study risk factors, etiology, clinical signs and treatment outcomes of invasive aspergillosis (IA) mucormycosis combination (IAM) in children. Materials Methods. A retrospective review Saint-Petersburg register (1998–2021) patients with IA was done children IAM were included. EORTC/MSGERG 2019 criteria used for diagnosing results evaluation mycosis. We presented a case child acute lymphoblastic leukemia relapse. Results. total 12 They accounted 8% all pediatric (n = 152). diagnosed hematological malignancies solid tumors from 4 to 16 years (median age – 11.5 years), mostly girls (83%). Main factors prolonged lymphopenia (75%, median 22 days) neutropenia (67%, 30 due chemotherapy, systemic corticosteroids and/or immunosuppressive therapy, as well HSCT. The predominant etiological agents Aspergillus niger (33%), A. nidulans (33%) fumigatus (17%), Lichtheimia corymbifera (50%) Rhizomucor spp. (50%). Based on criteria, «proven» 83% patients, «probable» 17%. «Probable» found 100% patients. most common sites the lungs (75%) paranasal sinuses (43%), multifocal involvement revealed 33% Mucormycosis developed during antifungal therapy Antifungal received 75% (amphotericin B lipid complex 89%, posaconazole 78%, caspofungin 33%), combined 33%, surgery 50%; surgical 42% overall 12-week survival 77.8%. use significantly improved (p 0.023). Conclusions. IA. (83%), (67%) against background In development increased mortality prognosis