title: Two cases of disseminated mucormycosis in patients following allogeneic bone marrow transplantation.
abstract: We describe two cases of disseminated mucormycosis following allogeneic bone marrow transplantation (BMT). Both patients were suffering from chronic graft-ver-sus-host disease (GVHD) and treated with prolonged administration of corticosteroid. In both cases, the initial symptoms were high fever and left flank pain. Involved organs were the spleen, right kidney and the right lung in one case, and the spleen and the brain in the other. The diagnosis was confirmed by pathology after splenectomy. One patient, in whom the immunosuppressants could be discontinued, was treated with prolonged conventional and liposomal amphotericin B and 5-fluorocytosine. The other, in whom the immunosuppressants could not be discontinued due to extensive GVHD, was unresponsive to amphotericin B, and eventually died from the fungal infection. Although mucormycosis, especially the disseminated form thereof is infrequent, it should be considered in high-risk patients because early diagnosis and timely therapy combining antifungal drug or surgery and reduction of immunosuppression appear to improve the prognosis.
authors.affiliation: The Catholic Hemopoietic Stem Cell Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Dong-Gun
authors.initials: DG
authors.lastname: Lee
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Su-Mi
authors.initials: SM
authors.lastname: Choi
authors.forename: Jin-Hong
authors.initials: JH
authors.lastname: Yoo
authors.forename: Yoo-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Min
authors.forename: Seok
authors.initials: S
authors.lastname: Lee
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Wan-Shik
authors.initials: WS
authors.lastname: Shin
authors.forename: Chun-Choo
authors.initials: CC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D009091:Mucormycosis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D014184:Transplantation, Homologous
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D000666:Amphotericin B