Iron overload is a risk factor for zygomycosis.
Well-recognized risk factors for zygomycosis include diabetic ketoacidosis, immunocompromise, and deferoxamine therapy for iron or aluminum overload, usually in patients undergoing kidney dialysis. We report a case of fatal nasal-orbital-cerebral zygomycosis in an 82-year-old man with known myelodysplasia and well-controlled diabetes. He was not receiving deferoxamine. Despite radical surgery and amphotericin B therapy, he died; primary hemochromatosis with gross iron overload was found post mortem. Experimental evidence suggests iron overload without deferoxamine therapy may be a risk factor for zygomycosis; the findings in this case would support this hypothesis.
McNab
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Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
McKelvie
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D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006801:Humans; D007501:Iron / Q000378:metabolism; D019190:Iron Overload / Q000150:complications* / Q000378:metabolism; D008297:Male; D009089:Mucor / Q000302:isolation & purification; D009091:Mucormycosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017233:Orbit Evisceration; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D000666:Amphotericin B; D007501:Iron