amphotericin-b and Intestinal-Pseudo-Obstruction

We report here the isolation of Mucor velutinosus from multiple blood cultures performed on samples from Broviac catheters and culture of a Broviac insertion-site wound sample from a 6-year-old boy with a history of intestinal failure secondary to chronic intestinal pseudo-obstruction, parenteral nutrition, and jejunostomy tube dependence. Examination of a slide from the culture revealed the presence of wide nonseptate hyphae with sporangiophores, columella, and chlamydospores. The fungal isolate was sent to the National Institutes of Health for further evaluation and was identified as Mucor velutinosus by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry and genomic sequencing. The patient was treated successfully with intravenous amphotericin B and prompt removal of his central line. To the best of our knowledge, this is the first case of M velutinosus bloodstream infection in a child without cancer.

Topics: Amphotericin B; Antifungal Agents; Catheter-Related Infections; Central Venous Catheters; Child; Fungemia; Humans; Immunocompetence; Intestinal Pseudo-Obstruction; Jejunostomy; Male; Mucor; Mucormycosis; Parenteral Nutrition