{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T02:33:11Z","timestamp":1778293991994,"version":"3.51.4"},"reference-count":15,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,9,27]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>Pulmonary mucormycosis (PM) accounts for more than half the cases of mucormycosis in paediatric haematological malignancies, with mortality reaching as high as 90%. Surgical debridement of lesion along with liposomal amphotericin B (L-AMB) constitutes the mainstay of management of mucormycosis and offers best chances of survival. There are no reliable data available in the literature justifying the use of combination antifungal therapy (CAfT). We describe a child with acute lymphoblastic leukaemia (ALL) who developed multiple localised PM during induction chemotherapy. He was managed with CAfT with L-AMB and caspofungin in view of progressive PM on high-dose L-AMB monotherapy. There was complete resolution of PM after 6\u2009months of CAfT at the end of intensive chemotherapy of ALL. There were no significant side effects of CAfT. CAfT may be of value in cases of mucormycosis refractory to high doses of L-AMB, where surgical debridement is not feasible.<\/jats:p>","DOI":"10.1136\/bcr-2021-245329","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T13:44:12Z","timestamp":1634651052000},"page":"e245329","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Favourable outcome in a child with acute lymphoblastic leukaemia and pulmonary mucormycosis managed with combination antifungal therapy of liposomal amphotericin B and caspofungin"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-8340","authenticated-orcid":false,"given":"Sanjeev","family":"Khera","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pathology, Army Hospital Research & Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somali","family":"Pattanayak","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"2025082706492188000_14.10.e245329.1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/bjh.16329","article-title":"Mucormycosis in children with haematological malignancies is a salvageable disease: a report from the Israeli study group of childhood leukemia","volume":"189","author":"Elitzur","year":"2020","journal-title":"Br J Haematol"},{"key":"2025082706492188000_14.10.e245329.2","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1093\/jpids\/piz007","article-title":"Pediatric mucormycosis: a 10-year systematic review of reported cases and review of the literature","volume":"8","author":"Otto","year":"2019","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2025082706492188000_14.10.e245329.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-016-2005-1","article-title":"Invasive mucormycosis in children: an epidemiologic study in European and non-European countries based on two registries","volume":"16","author":"Pana","year":"2016","journal-title":"BMC Infect Dis"},{"key":"2025082706492188000_14.10.e245329.4","doi-asserted-by":"crossref","first-page":"e405","DOI":"10.1016\/S1473-3099(19)30312-3","article-title":"Global guideline for the diagnosis and management of mucormycosis: an initiative of the European confederation of medical mycology in cooperation with the mycoses Study Group education and research Consortium","volume":"19","author":"Cornely","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"2025082706492188000_14.10.e245329.5","doi-asserted-by":"publisher","DOI":"10.1086\/589857"},{"key":"2025082706492188000_14.10.e245329.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2016.03.029"},{"key":"2025082706492188000_14.10.e245329.7","unstructured":"ICiCLe - NCG. 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