Cutaneous mucormycosis in an acute lymphoblastic leukemia child during bone marrow suppression: A case report

Abstract

Mucormycosis is a common pathogen infecting acute lymphoblastic leukemia patients in bone marrow suppression period after chemotherapy. Infection of mucormycosis on skin is relatively rare. In this study, we present a 7-year-old boy diagnosed as acute lymphoblastic leukemia with myeloid expression and mucormycosis infection on skin. Cutaneous mucormycosis occurred on the right forearm after chemotherapy with increasing manifestations of recurrent fever, local skin necrosis and eschar, skin temperature elevation, and swelling painful feeling of right forearm. Tissue smear examination and cell culture results showed that the patient was with mucormycosis infection. Local debridement was carried out and amphotericin B applied for anti-fungal infection treatment. Although constitutional symptom was controlled after anti-infection therapy, surrounding muscles that were affected by the local necrosis kept getting worse. Therefore, free flap transplantation was undertaken along with surgical debridement, and the patient was cured with right hand function preserved completely. Follow-up examination showed that the child entered the maintain chemotherapy stage for leukemia and the local skin was growing well without infection again. In summary, our result indicated that although mucormycosis is hazardous and fatal, early detection and treatment can significantly reduce the mortality whereas drug therapy combined with surgical treatment could further enhance the cure rate.