Zygomycosis in Immunocompetent Children in Iran : Case Series and Review

The class Zygomycetes is divided into two orders, Mucorales and Entomophthorales. Members of these two orders produce dramatically different infections. The fungi in Entomophthorales which encompass 2 genera: Conidiobolus and Basidiobolus are uncommon pathogens causing chronic cutaneous and subcutaneous infections in immunocompetent patients and rarely disseminate to internal organs and typically are restricted to the tropical and subtropical regions. In the present report, four cases of zygomycosis in immunocompetent children have been presented, which were diagnosed over two-year period 2010 -2012 in southern of Iran on the basis of the histopathologic findings. According to a PubMed search of the English language literature, three other cases of zygomycosis in immunocompetent patients in Iran reported. Surgical resection of the infected tissue and prolonged treatment with AmB followed by a combination of itraconazole and TMP/SMX had an excellent result in these patients. In an immunocompetent patient who presented with eosinophilia,anemia and a mass in different sites such as liver, intestine and other soft tissues in tropical and subtropical area, obtaining specimens for fungal culture and histopathologic examination with special fungal stains seems crucial.

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