{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:33:58Z","timestamp":1785371638780,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Background: Mucormycosis is a life-threatening infection with a tendency for angioinvasion that may lead to progressive dissemination. Disseminated mucormycosis, defined as the involvement of two or more non-contiguous sites, is rare in children, and data concerning its management and outcome are scarce. The aim of this study was to assess the contemporary management strategies and outcomes of disseminated mucormycosis in the pediatric population. Methods: We conducted a retrospective search in six large tertiary medical centers for all cases of disseminated mucormycosis that occurred between 2009\u20132020 in patients aged 1\u201320 years. Results: Twelve cases were identified. Underlying conditions included hematological malignancies (n = 10), solid tumor (post-autologous hematopoietic stem cell transplantations; n = 1), and solid organ (liver) transplantation (n = 1). In all cases, amphotericin B formulations were administered as first-line therapy; in eight cases, they were also administered in combination with an echinocandin or triazole. Seven patients underwent surgical debridement procedures. The six-week mortality was 58%. Among the patients diagnosed between 2009\u20132015, one of the six survived, and of those diagnosed between 2016\u20132020, four of the six were salvaged. Conclusions: Disseminated mucormycosis is a life-threatening and often fatal disease, and improved diagnostic and therapeutic strategies are needed. Nevertheless, in this population-based study, five patients (42%) were salvaged through combined liposomal amphotericin\/triazole treatment and extensive surgical interventions.<\/jats:p>","DOI":"10.3390\/jof7030165","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T02:08:17Z","timestamp":1614305297000},"page":"165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Disseminated Mucormycosis in Immunocompromised Children: Are New Antifungal Agents Making a Difference? A Multicenter Retrospective Study"],"prefix":"10.3390","volume":"7","author":[{"given":"Sarah","family":"Elitzur","sequence":"first","affiliation":[{"name":"The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children\u2019s Medical Center, 4920235 Petah Tikva, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Fischer","sequence":"additional","affiliation":[{"name":"The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children\u2019s Medical Center, 4920235 Petah Tikva, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nira","family":"Arad-Cohen","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology Department, Ruth Rappaport Children\u2019s Hospital, Rambam Health Care Campus, 3109601 Haifa, Israel"},{"name":"Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 3200003 Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assaf","family":"Barg","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel"},{"name":"Division of Pediatric Hematology, Oncology and BMT, The Edmond and Lily Safra Children\u2019s Hospital, Sheba Medical Center, 5262161 Ramat Gan, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Ben-Harosh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology-Oncology, Soroka Medical Center, Ben Gurion University, 8489501 Beer Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4819-3871","authenticated-orcid":false,"given":"Dana","family":"Danino","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit Soroka Medical Center, Ben Gurion University, 8489501 Beer Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronit","family":"Elhasid","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel"},{"name":"Department of Pediatric Hemato-Oncology, Sourasky Medical Center, 6423906 Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aharon","family":"Gefen","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology Department, Ruth Rappaport Children\u2019s Hospital, Rambam Health Care Campus, 3109601 Haifa, Israel"},{"name":"Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 3200003 Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Gilad","sequence":"additional","affiliation":[{"name":"The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children\u2019s Medical Center, 4920235 Petah Tikva, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itzhak","family":"Levy","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel"},{"name":"Pediatric Infectious Disease Unit, Schneider Children\u2019s Medical Center, 4920235 Petah Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Shachor-Meyouhas","sequence":"additional","affiliation":[{"name":"Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 3200003 Haifa, Israel"},{"name":"Pediatric Infectious Disease Unit, Ruth Rappaport Children\u2019s Hospital, Rambam Health Care Campus, 3109601 Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigal","family":"Weinreb","sequence":"additional","affiliation":[{"name":"Pediatric Hematology-Oncology, Hadassah Hebrew University Medical Center, 9112000 Jerusalem, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Izraeli","sequence":"additional","affiliation":[{"name":"The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children\u2019s Medical Center, 4920235 Petah Tikva, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3994-0556","authenticated-orcid":false,"given":"Shlomit","family":"Barzilai-Birenboim","sequence":"additional","affiliation":[{"name":"The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children\u2019s Medical Center, 4920235 Petah Tikva, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1093\/cid\/cir880","article-title":"A Global Analysis of Mucormycosis in France: The RetroZygo Study (2005\u20132007)","volume":"54","author":"Lanternier","year":"2012","journal-title":"Clin. 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