Invasive fungal infection in a child with Ewing’s sarcoma

Invasive fungal infection (IFI) in patients with malignant solid tumours is rare, but it highly increases the risk of cancer recurrence because of prolonged discontinuation of cancer treatment. This paper presents a case of IFI induced by Candida glabrata in a 14-year-old girl with advanced Ewing’s sarcoma and metastases to the bone marrow. She was intensively treated with chemotherapy (CWS, CEVAIE, EWING 2008 + VIDE) and radiotherapy. As the treatment was ineffective, the tumour was surgically removed from the sacrum, and VAI chemotherapy was administered. Due to the symptoms of infection, antifungal treatment was initiated with caspofungin, followed by prophylaxis with posaconazole. In terms of anti-cancer treatment, the patient received megatherapy with auto-HSCT. Signs of infection and gastrotoxic complications developed, which is why broad-spectrum antibiotics and amphotericin B lipid complex were administered. Even so, a multisystem IFI appeared, causing the patient’s death. In multidrug chemotherapy with extended periods of agranulocytosis, primary prevention should be considered, similar to the one offered to patients with haematological malignancies.