{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T06:33:13Z","timestamp":1778049193600,"version":"3.51.4"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Aplastic anemia (AA), is a rare but potentially life-threatening disease characterized by pancytopenia and a hypocellular bone marrow. Pulmonary mucormycosis (PM) is a rare but life-threatening fungal infection observed in immunocompromised patients, particularly those with neutropenia and those using corticosteroids, with a high mortality rate from 40 to 80%. However, PM diagnosis and treatment remain challenging. This study reports a case of very severe aplastic anemia (VSAA) in a male child with PM. The innovation of this article lies in the following aspects: the patient exhibited typical clinical manifestations, the reverse halo sign (RHS) on chest computed tomography (CT), and a positive metagenomic next-generation sequencing (mNGS) analysis; despite aggressive anti-infective treatment and left lower lobectomy, he experienced a poor clinical outcome. Reflecting on cases with poor prognosis can indeed offer valuable insights and opportunities for learning. This study underlines the diagnostic challenges in mucormycosis, which should be considered in persistent fever that is unresponsive to standard antibiotic and antifungal therapies, and conduct a comprehensive examination to achieve early detection, diagnosis and treatment. It was concluded that, in addition to antifungal treatment, early surgery is essential for treating mucormycosis.<\/jats:p>","DOI":"10.3389\/fped.2024.1453059","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T04:40:37Z","timestamp":1726116037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Very severe aplastic anemia in a child with pulmonary mucormycosis: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Minchun","family":"Huang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanchuan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yahui","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1007\/s12185-015-1787-z","article-title":"The diagnosis and treatment of aplastic anemia: a review","volume":"101","author":"Miano","year":"2015","journal-title":"Int J Hematol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1093\/clinids\/20.1.176","article-title":"Fatal disseminated infection due to exserohilum rostratum in a patient with aplastic anemia: case report and review","volume":"20","author":"Aquino","year":"1995","journal-title":"Clin Infect Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.idc.2021.03.009","article-title":"Mucormycosis","volume":"35","author":"Steinbrink","year":"2021","journal-title":"Infect Dis Clin North Am"},{"key":"B4","doi-asserted-by":"publisher","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":"B5","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1055\/s-0031-1295717","article-title":"Pulmonary mucormycosis","volume":"32","author":"Hamilos","year":"2011","journal-title":"Semin Respir Crit Care Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1148\/rg.2020190156","article-title":"Pulmonary mucormycosis: risk factors, radiologic findings, and pathologic correlation","volume":"40","author":"Agrawal","year":"2020","journal-title":"RadioGraphics"},{"key":"B7","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1182\/asheducation-2011.1.76","article-title":"Diagnosis and management of aplastic anemia","volume":"2011","author":"Guinan","year":"2011","journal-title":"Hematology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.3324\/haematol.2017.164459","article-title":"Effect of antithymocyte globulin source on outcomes of bone marrow transplantation for severe aplastic anemia","volume":"102","author":"Kekre","year":"2017","journal-title":"Haematologica"},{"key":"B9","doi-asserted-by":"publisher","first-page":"518","DOI":"10.3324\/haematol.12020","article-title":"Epidemiology of aplastic anemia: a prospective multicenter study","volume":"93","author":"Montane","year":"2008","journal-title":"Haematologica"},{"key":"B10","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1016\/j.cmi.2020.12.035","article-title":"Has the mortality from pulmonary mucormycosis changed over time? 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