Abstract
Mucormycosis is an angioinvasive lethal fungal infection in pediatric
cancer patients. We present 10-year-old female with relapsed B-cell
acute lymphoblastic leukemia undergoing chemotherapy was diagnosed with
isolated cerebral mucormycosis (ICM). Despite surgical debridement and
liposomal amphotericin B, repeat
imaging showed concern for disease progression. Chemotherapy was
discontinued and the patient was discharged on salvage therapy oral
isavuconazole (ISAV). Over two months later, the patient was
unexpectedly clinically stable, and imaging showed near resolution.
After confirming continuous disease remission, the patient was restarted
on modified chemotherapy. Serial MRI’s during continued chemotherapy
showed stable MRI findings. This
case illustrates a rare presentation of successful salvage monotherapy
ISAV for this deadly infection with complete remission for relapsed
leukemia.