Mucormycosis and invasive aspergillosis complicating severe aplastic anemia are aggressive infections associated to high mortality in the lack of rapid neutrophil and monocyte recovery. We report a child who had severe aplastic anemia complicated by sinusal invasive aspergillosis and by Rhizopus arrhizus, probably breakthrough gingivitis, which occurred under voriconazole. She underwent a rescue sibling bone marrow transplantation considered as the only chance for survive. Use of fludarabine-containing conditioning, granulocyte colony-stimulating factor allowed rapid engraftment. Granulocyte transfusion and use of amphotericin B–voriconazole association permitted infection control, which was favored by immune recovery.
From the *Bone Marrow Unit, Centre National de Greffe de Moelle Osseuse (CNGMO), Tunis, Tunisia; †Radiology Department, Institut M T Kassab, Ksar-Said, Tunisia; ‡Department of Otorhinolaryngology, Hôpital Charles Nicole, Tunis, Tunisia; §Department of Mycology, Hôpital La Rabta, Tunis, Tunisia and ∥Apheresis Unit, Centre National de Transfusion sanguine, Tunis, Tunisia.
Correspondence to: Saloua Ladeb, MD, Centre National de Greffe de Moelle Osseuse, rue Jebel Lakhdhar, 1006 Bab Saadoun, Tunis, Tunisia. E-mail: email@example.com.
The authors have no funding or conflicts of interest to disclose.