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Recurrent Rhinocerebral Mucormycosis - A Case Report

Journal of the Korean Pediatric Society 1993;36(4):589-595.
Published online April 15, 1993.
Recurrent Rhinocerebral Mucormycosis - A Case Report
Ho Sung Kim1, Jin Young Park1, Bo Young Yun1, Eun Sil Dong1, Hee Young Shin1, Hoan Jong Lee1, Hyo Seop Ahn1, Je Geun Chi2, Myung Whun Sung3
1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
2Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
3Department of Otolayngology, Seoul National University College of Medicine, Seoul, Korea
급성 거핵구성 백혈병 환아에서 병발한 Rhinocerebral Mucormycosis 1례
김호성1, 박진영1, 윤보영1, 동은실1, 신희영1, 이환종1, 안효섭1, 지제근2, 성명훈3
1서울대학교 의과대학 소아과학교실
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 병리학교실
3서울대학교 의과대학 이비인후과학교실
Abstract
A case of recurrent rhinocerebral mucormycosis that has occurred during an induction chemotherapy for acute megakaryocytic leukemia in a 10 year-old boy is reported. He had suffered from high fever, proptosis, right eye ball pain and necrotic inflammation of hard palate during the chemotherapy of leukemia. CT scan of the paranasal sinus showed inflammatory change of right ethmoid and maxillary sinuses, and right orbital cystic mass which displaced medial rectus muscle. Pathologic examination of the inflammatory mass revealed mucormycosis with characteristic hyphae invading vessel walls. He was managed with 2 times of extensive debridement of necrotic tissue and currettage of cystic mass, and intravenous amphotericin-B for 80 days with apparent improvement. Seven months after discharge from the hospital, necrosis of posterior nasal septum and hard palate was noted for the second time. It was managed again with 2 times of extensive debridement. Since this last operation he is on follow-up for 16 months uneventfully and is on therapy with low dose Ara-C in continuous remission.
Key Words: Rhinocerebral mucormycosis, Recurrent, Acute megakaryocytic leukemia


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