{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:02:30Z","timestamp":1779951750579,"version":"3.53.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["SCU2023G4175"],"award-info":[{"award-number":["SCU2023G4175"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82572491"],"award-info":[{"award-number":["82572491"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012542","name":"Sichuan Provincial Science and Technology Support Program","doi-asserted-by":"publisher","award":["2023ZYD0120"],"award-info":[{"award-number":["2023ZYD0120"]}],"id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>\n                    Pediatric infections caused by\n                    <jats:italic>Cunninghamella bertholletiae (C. bertholletiae)<\/jats:italic>\n                    are exceedingly rare with only few published case reports. Herein, we describe five cases of\n                    <jats:italic>C. bertholletiae<\/jats:italic>\n                    diagnosed and treated in Pediatric Hematology-Oncology Patients. These cases indicated that pediatric\n                    <jats:italic>C. bertholletiae<\/jats:italic>\n                    infection presents with non-specific clinical features, is associated with high fatality, and frequently involves multiple anatomical sites, most commonly the lungs, demonstrating epidemiological patterns distinct from those observed in adults. From a diagnostic perspective, mNGS enables rapid pathogen identification, facilitates timely initiation of antifungal therapy, and may improve survival. Therapeutically, surgical intervention is associated with a significant reduction in mortality. Although combination therapy and monotherapy appear to have comparable overall efficacy, sequential monotherapy demonstrates a more pronounced survival benefit. Furthermore, Isavuconazole represents an effective salvage option and is linked to a significant decrease in mortality.\n                  <\/jats:p>","DOI":"10.3389\/fped.2026.1847039","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:16:58Z","timestamp":1779949018000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Invasive Cunninghamella bertholletiae Infections in children: a case series and literature review"],"prefix":"10.3389","volume":"14","author":[{"given":"Xue","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunjiao","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiakai","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanjie","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangfei","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Pathology, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanjuan","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Pediatric, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.cmi.2018.07.011","article-title":"The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports","volume":"25","author":"Jeong","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"B2","doi-asserted-by":"publisher","first-page":"657","DOI":"10.3390\/diagnostics12030657","article-title":"Disseminated cunninghamella spp. endocarditis in a beta-thalassemia patient after asymptomatic COVID-19 infection","volume":"12","author":"Cinteza","year":"2022","journal-title":"Diagnostics"},{"key":"B3","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":"B4","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.pedneo.2014.04.010","article-title":"Disseminated Cunninghamella bertholletiae infection during induction chemotherapy in a girl with high-risk acute lymphoblastic leukemia","volume":"57","author":"Su","year":"2016","journal-title":"Pediatr Neonatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-10905-7","article-title":"The first report of pseudoaneurysm secondary to Cunninghamella bertholletiae infection in a haematopoietic stem cell transplantation recipient: a case report and literature review","volume":"25","author":"Ding","year":"2025","journal-title":"BMC Infect Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1093\/jpids\/pix107","article-title":"Mucormycosis in children: review and recommendations for management","volume":"7","author":"Francis","year":"2018","journal-title":"J Pediatric Infect Dis Soc"},{"key":"B7","doi-asserted-by":"publisher","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":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1273073","article-title":"Rapid detection of mucorales based on recombinase polymerase amplification and real-time PCR","volume":"14","author":"Xu","year":"2023","journal-title":"Front Microbiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/j.jinf.2020.05.051","article-title":"Evaluation of MucorGenius\u00ae mucorales PCR assay for the diagnosis of pulmonary mucormycosis","volume":"81","author":"Guegan","year":"2020","journal-title":"J Infect"},{"key":"B10","doi-asserted-by":"publisher","first-page":"264.e5","DOI":"10.1016\/j.ajem.2020.09.032","article-title":"Mucormycosis with orbital compartment syndrome in a patient with COVID-19","volume":"42","author":"Werthman-Ehrenreich","year":"2021","journal-title":"Am J Emerg Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1093\/cid\/ciab1066","article-title":"Evaluation of Serum mucorales polymerase chain reaction (PCR) for the diagnosis of mucormycoses: the MODIMUCOR prospective trial","volume":"75","author":"Millon","year":"2022","journal-title":"Clin Infect Dis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"694756","DOI":"10.3389\/fcimb.2021.694756","article-title":"The diagnostic value of metagenomic next-generation sequencing in lower respiratory tract infection","volume":"11","author":"Zheng","year":"2021","journal-title":"Front Cell Infect Microbiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1368165","DOI":"10.3389\/fcimb.2024.1368165","article-title":"Clinical features of pediatric mucormycosis: role of metagenomic next generation sequencing in diagnosis","volume":"14","author":"Zhang","year":"2024","journal-title":"Front Cell Infect Microbiol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-10439-y","article-title":"Use of isavuconazole in mucormycosis: a systematic review","volume":"25","author":"Gunathilaka","year":"2025","journal-title":"BMC Infect Dis"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1128\/aac.00484-24","article-title":"Safety, outcomes, and pharmacokinetics of isavuconazole as a treatment for invasive fungal diseases in pediatric patients: a non-comparative phase 2 trial","volume":"68","author":"Segers","year":"2024","journal-title":"Antimicrob Agents Chemother"},{"key":"B16","first-page":"282","article-title":"Zygomycosis caused by Cunninghamella bertholletiae: clinical and pathologic aspects","volume":"106","author":"McGinnis","year":"1982","journal-title":"Arch Pathol Lab Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1097\/MPH.0000000000000235","article-title":"Aggressive Cunninghamella pneumonia in an adolescent","volume":"36","author":"Malkan","year":"2014","journal-title":"J Pediatr Hematol Oncol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"831363","DOI":"10.3389\/fped.2022.831363","article-title":"Case report: is surgical treatment beneficial for intracranial basal ganglia cunninghamellamycosis following haematopoietic stem cell transplantation?","volume":"10","author":"Xi","year":"2022","journal-title":"Front Pediatr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e109","DOI":"10.1097\/MPH.0b013e31829eec5a","article-title":"Cunninghamella bertholletiae infection in children","volume":"36","author":"Carceller","year":"2014","journal-title":"J Pediatr Hematol Oncol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.diagmicrobio.2013.03.009","article-title":"Cunninghamella echinulata causing fatally invasive fungal sinusitis","volume":"76","author":"LeBlanc","year":"2013","journal-title":"Diagn Microbiol Infect Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1093\/clinids\/17.2.173","article-title":"Cunninghamella infections: review and report of two cases of Cunninghamella Pneumonia in immunocompromised children","volume":"17","author":"Cohen-Abbo","year":"1993","journal-title":"Clin Infect Dis"},{"key":"B22","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1111\/myc.12010","article-title":"Focus on invasive mucormycosis in paediatric haematology oncology patients: a series of 11 cases","volume":"56","author":"Phulpin-Weibel","year":"2013","journal-title":"Mycoses"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e0179136","DOI":"10.1371\/journal.pone.0179136","article-title":"Increasing incidence of mucormycosis in a large Spanish hospital from 2007 to 2015: epidemiology and microbiological characterization of the isolates","volume":"12","author":"Guinea","year":"2017","journal-title":"PLoS One"},{"key":"B24","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.mycmed.2006.06.003","article-title":"Infection pulmonaire \u00e0 Cunninghamella bertholletiae chez une jeune patiente leuc\u00e9mique","volume":"16","author":"Gari-Toussaint","year":"2006","journal-title":"J Mycol M\u00e9d"},{"key":"B25","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1097\/INF.0000000000002671","article-title":"Isavuconazole as successful salvage therapy for mucormycosis in pediatric patients","volume":"39","author":"Ashkenazi-Hoffnung","year":"2020","journal-title":"Pediatr Infect Dis J"},{"key":"B26","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s11046-018-0287-0","article-title":"Isavuconazole in a successful combination treatment of disseminated mucormycosis in a child with acute lymphoblastic leukaemia and generalized haemochromatosis: a case report and review of the literature","volume":"184","author":"Pomorska","year":"2018","journal-title":"Mycopathologia"},{"key":"B27","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1002\/1097-0142(195903\/04)12:2%3C330::AID-CNCR2820120217%3E3.0.CO;2-F","article-title":"Phycomycetous infection (mucormycosis) in cancer patients: a complication of therapy","volume":"12","author":"Hutter","year":"1959","journal-title":"Cancer"},{"key":"B28","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/S0242-6498(07)91302-4","article-title":"Pneumopathie \u00e0 Cunninghamella bertholletiae compliquant une leuc\u00e9mie aig\u00fce lymphoblastique","volume":"27","author":"Lassalle","year":"2007","journal-title":"Ann Pathol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1111\/j.1440-1843.2008.01240.x","article-title":"Pulmonary mucormycosis (Cunninghamella bertholletiae) with cavitation diagnosed using ultra-thin fibre-optic bronchoscopy","volume":"13","author":"Yagi","year":"2008","journal-title":"Respirology"},{"key":"B30","first-page":"43","article-title":"Pulmonary zygomycosis caused by cunninghamella bertholletiae in a child with acute lymphoblastic leukemia","volume":"12","author":"Bibashi","year":"2008","journal-title":"Hippokratia"},{"key":"B31","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1097\/MPH.0b013e3181c2bdce","article-title":"Report of a successful treatment of pulmonary Cunninghamella bertholletiae infection with liposomal amphotericin and posaconazole in a child with GvHD and review of the literature","volume":"32","author":"Garbino","year":"2010","journal-title":"J Pediatr Hematol Oncol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1097\/TP.0b013e3181f86916","article-title":"Successful treatment of cutaneous zygomycosis with intravenous amphotericin B followed by oral posaconazole in a multivisceral transplant recipient","volume":"90","author":"Ashkenazi-Hoffnung","year":"2010","journal-title":"Transplantation"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e30788","DOI":"10.1002\/pbc.30788","article-title":"Successful treatment of disseminated mucormycosis in a pediatric patient with wilms tumor","volume":"71","author":"Gerber","year":"2024","journal-title":"Pediatr Blood Cancer"},{"key":"B34","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1097\/00006454-199809000-00019","article-title":"Survival from pulmonary infection with Cunninghamella bertholletiae: case report and review of the literature","volume":"17","author":"Mazade","year":"1998","journal-title":"Pediatr Infect Dis J"},{"key":"B35","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.arbres.2012.04.023","article-title":"Zygomycosis in children: disseminated infection caused by Cunninghamella bertholletiae","volume":"49","author":"Gonz\u00e1lez-Abad","year":"2013","journal-title":"Arch Bronconeumol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2800","DOI":"10.11816\/cn.ni.2025-250831","article-title":"Investigation of hospital-acquired pulmonary mucormycosis caused by cunninghamella bertholletiae in a child and its prevention and control","volume":"35","author":"Liu","year":"2025","journal-title":"Chin J Nosocomial Infect"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1847039\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:17:00Z","timestamp":1779949020000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1847039\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":36,"alternative-id":["10.3389\/fped.2026.1847039"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1847039","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]},"article-number":"1847039"}}