Cutaneous invasive fungal infections in pediatric hematological malignancies: A case series and review of literature

Abstract

Background: Cutaneous invasive fungal infections are a highly feared complication of cancer chemotherapy in children. The increased risk for these infections is often attributed to the profound immunosuppression and neutropenia resulting from intensive chemotherapy. Common pathogens include Zygomycetes, Aspergillus, and Candida species, each showing a wide array of clinical manifestations. Case report: We describe an outbreak of four cases of cutaneous invasive fungal infections in children undergoing induction chemotherapy for hematological malignancies from a pediatric hematology and oncology unit in India. Aspergillus and Zygomycetes infections and their varying clinical manifestations, along with diagnostic and treatment challenges, are highlighted. Iatrogenic skin breach and neutropenia were common risk factors observed in all four cases. Conclusion: Prompt microbiological diagnosis, early initiation of antifungals, and effective local control measures are essential to obtain improved outcomes. Mortality and morbidity rates continue to remain high despite numerous antifungal agents.

Keywords

• Mucormycosis
• Aspergillus
• Pediatric ALL
• Chemotherapy
• Childhood cancers