{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:39:04Z","timestamp":1766489944480,"version":"3.48.0"},"reference-count":27,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Invasive Mucormycosis (IM) is an extremely rare infection with a high mortality rate, caused by a group of fungi classified as Mucorales moulds. Rhizomucor pusillus is a saprophitic, thermophilic, and angioinvasive microorganism that grows and lives at about 45 \u00b0C and is usually found in different environmental spaces such as soil, air, water, food, and other organic matter. These features predispose the infection to wide dissemination, especially in immunocompromised patients and most often in children after chemotherapy for hematological malignancies (HMs). Mucormycosis in patients with hematologic malignancies and neutropenia represents between 0.07% and 4.29% of the concomitant diseases. IM can develop into an infection in different sites, but its most common manifestation is pulmonary, followed by rhino-orbital\u2013cerebral and disseminated forms. In recent years, an increased morbidity rate has been associated with the ongoing COVID-19 pandemic, as cited in the literature. There are many publications with COVID-19-associated mucormycosis (CAM) cases. The present treatment protocol includes extensive and radical surgical debridement and systemic antifungal therapy with Liposomal Amphotericin B (L-AmB), Posaconazole, and Isavuconazole, either combined or as monotherapy. Despite these new treatment modalities, the mortality rate remains over 50%. We present a rare case of a 3-year-old child with acute lymphoblastic leukemia (ALL) and systemic Rhizomucor pusillus infection, diagnosed on the occasion of lung and brain abscesses. The patient underwent lung and brain surgery and is recovering well with no further complications. The two-year follow-up period shows no signs of recurrence of the disease.<\/jats:p>","DOI":"10.3390\/idr18010002","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:57:18Z","timestamp":1766487438000},"page":"2","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Rare Case of Rhizomucor pusillus Infection in a 3-Year-Old Child with Acute Lymphoblastic Leukemia, Presenting with Lung and Brain Abscesses\u2014Case Report"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1554-8565","authenticated-orcid":false,"given":"Yanko","family":"Pahnev","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boryana","family":"Avramova","sequence":"additional","affiliation":[{"name":"Department for Pediatric Hematology and Oncology, University Hospital \u2018Quin Joanna\u2019, 1527 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Gabrovska","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Specialized Hospital for Active Treatment of Children\u2019s Diseases \u201cProf. Ivan Mitev\u201d, Medical University-Sofia, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolin","family":"Dontcheva","sequence":"additional","affiliation":[{"name":"Department for Pediatric Hematology and Oncology, University Hospital \u2018Quin Joanna\u2019, 1527 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genoveva","family":"Tacheva","sequence":"additional","affiliation":[{"name":"Children Neurology Unit, Department of Pediatric Neurology, University Pediatrics Hospital, Medical University-Sofia, 1000 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1203-2870","authenticated-orcid":false,"given":"Krasimir","family":"Minkin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital St. Ivan Rilski, 1407 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Kreipe","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Medical School Hannover, 30559 Hanover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadezhda","family":"Yurukova","sequence":"additional","affiliation":[{"name":"Department for Pediatric Hematology and Oncology, University Hospital \u2018Quin Joanna\u2019, 1527 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marin","family":"Penkov","sequence":"additional","affiliation":[{"name":"Department for Pediatric Hematology and Oncology, University Hospital \u2018Quin Joanna\u2019, 1527 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikola","family":"Kartulev","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zdravka","family":"Antonova","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Velichka","family":"Oparanova","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadezhda","family":"Tolekova","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petia","family":"Moutaftchieva","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan","family":"Mladenov","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology and Intensive Care, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Plamena","family":"Hristova","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology and Intensive Care, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaloyan","family":"Gabrovski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital St. Ivan Rilski, 1407 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3347-2798","authenticated-orcid":false,"given":"Svetlana","family":"Velizarova","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Specialized Hospital for Active Treatment of Children\u2019s Diseases \u201cProf. Ivan Mitev\u201d, Medical University-Sofia, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albena","family":"Spasova","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Specialized Hospital for Active Treatment of Children\u2019s Diseases \u201cProf. Ivan Mitev\u201d, Medical University-Sofia, 1606 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hristo","family":"Shivachev","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Multiprofile Hospital for Active Treatment and Emergency Medicine \u2018N.I.Pirogov\u2019, 1606 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