Reactions 1254 - 30 May 2009

SAntineoplastics

Hard palatal perforation due to mucormycosis ina child: case report

An 8-year-old boy developed a mucormycosis infectionleading to a hard palatal perforation, while undergoingchemotherapy treatment for acute lymphoblasticleukaemia (ALL-L1).

Following his diagnosis, the boy started inductiontreatment with vincristine, daunorubicin, asparaginase[Leucogenase], oral prednisolone and intrathecalmethotrexate (MCP-841 protocol) [dosages not stated]. Hewas also administered antibacterials and granulocytemacrophage colony stimulating factor for febrileneutropenia that developed after each week of therapy.Anaemia necessitated blood transfusions. During thefourth week of chemotherapy, he reported nasal pain.Examination revealed a broadening of the nasal bridge andan ulcer crater (3 × 3cm) in his hard palate with a necroticeschar on it. A biopsy of the lesion demonstratednonseptate mucormycotic hyphae with acute right anglebranching invading blood vessels. There was also growth ofmucormycosis hyphae evident in the tissue culture.

The boy underwent surgical debridement of the necroticarea. He subsequently received amphotericin B liposomal,and after the infection was controlled, he was fitted with apalatal prosthesis. A palatoplasty was scheduled for a laterdate. At last follow-up, chemotherapy was continuing.

Author comment: "The reported case was diagnosed as acase of ALL-L1 who was on prolonged chemotherapy and oralcorticosteroids and hence more susceptible to mucormycosisinfection."Samanta DR, et al. Hard palate perforation in acute lymphoblastic leukemia due tomucormycosis - a case report. Indian Journal of Hematology and BloodTransfusion 25: 36-39, No. 1, 2009 - India 801141686

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Reactions 30 May 2009 No. 12540114-9954/10/1254-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved