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Introduction: During the era of COVID-19, an increase has surged in the number of cases of mucormycosis; the use of high doses of steroids, and states of immunosuppression such as diabetes are the main related risk factors. In the treatment of acute leukemia, it is recommended to reduce the dose of chemotherapy, postponing highly myeloablative schemes and the use of caution with monoclonal antibodies. Case presentation: We present the case of a patient (25 years-old male) with acute lymphoblastic leukemia and COVID-19 confirmed infection who developed rhino-cerebral mucormycosis during the induction stage. Conclusion: In the age of COVID-19, taking samples through a nasal swab should be avoided in individuals with risk of infection from mucormycosis, such as diabetes, cancer, or individuals treated with high doses of steroids.

Intrathecal chemoprophylaxis prevents central nervous system relapses in patients with acute lymphoblastic leukaemia (ALL) but few studies have addressed the predictive markers of relapse. Among these, traumatic lumbar puncture (TLP) has been associated with lower disease-free survival (DFS). To investigate the risk posed by TLP on relapse and DFS, we assembled a retrospective cohort including 79 patients with ALL who received intrathecal chemoprophylaxis during 2009 to 2013. One TLP per patient was recorded in 49 cases, and more than one TLP in 3. Mean follow-up was 283 (22–1118) days with an overall DFS of 68%. DFS was significantly lower in the group that had experienced TLP (58% vs 100% [ P = .070]). Multiple TLP posed a greater risk of relapse than single TLP ( P = .001). In conclusion, TLP in adults constitutes a major risk factor, greater than that reported in the large paediatric series.

The nasal colonization by Staphylococcal (epidermidis or aureus) is frequent and it has importance when it is associated to bacteremia in immunocompromised patients. The objective was to determine the frequency of strains that colonize the nasal mucosa in patients with leukemia and its relationship with peripheral blood cultures.A retrospective, observational, transversal, retrolective study was done. We analyzed the weekly results of nasal cultures and peripheral blood cultures in patients with leukemia undergoing chemotherapy. The chi-squared test and odds ratio value were estimated in the statistical analysis.We included 67 patients, 55 of them with acute lymphocytic leukemia (ALL); 28.5 % of the cultures (n = 47) corresponded to a positive nasal culture. Staphylococcus epidermidis and Staphylococcus aureus were the most isolated bacteria. During the first week of treatment, the positive cultures were the most frequently. All the samples isolated were sensitive to vancomycin or linezolid. It was established only the association between negative nasal cultures and negative peripheral blood cultures (p = 0.0005). Odds ratio for positive nasal cultures and the risk of bacteremia was 0.0269.The frequency of the positive bacteria culture was low, with an adequate sensitivity measure. The presence of bacteria in nasal culture was not identified as a risk factor for the occurrence of bacteremia.INTRODUCCIÓN: la colonización nasal por Staphylcoccus epidermidis y Staphylococcus aureus es frecuente y se ha relacionado con bacteremia en huéspedes inmunocomprometidos. En la investigación que se presenta, los objetivos fueron determinar la frecuencia de cepas que colonizan la mucosa nasal en pacientes en tratamiento de leucemia aguda y su relación con los cultivos de sangre periférica. MÉTODOS: estudio retrospectivo, observacional, transversal, retrolectivo de cultivos nasales obtenidos durante cuatro semanas. La relación con los hemocultivos se estableció mediante chi cuadrada; se calculó razón de momios.se estudiaron 67 casos, en su mayoría con leucemia linfoblástica aguda (n = 55). De 165 cultivos nasales, 28.5 % fue positivo (n = 47). Las principales bacterias identificadas fueron Staphylcoccus epidermidis y Staphylococcus aureus. La primera semana de tratamiento fue el principal momento de aislamiento. Todas las cepas fueron sensibles a vancomicina o linezolid. Se estableció relación entre los cultivos nasales y los hemocultivos negativos (p = 0.0005). La razón de momios para los cultivos nasales positivos respecto a los hemocultivos y el riesgo de bacteremia fue de 0.0269 (IC 95 % = 0.0016, 0.4484).se aislaron pocas bacterias en la mucosa nasal, y la sensibilidad de estas a los antibióticos fue adecuada. La presencia de bacterias en la mucosa nasal no fue un factor de riesgo para la aparición de bacteremia.