Two cases of disseminated mucormycosis in patients following allogeneic bone marrow transplantation.
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.
Lee
Dong-Gun
DG
The Catholic Hemopoietic Stem Cell Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Choi
Jung-Hyun
JH
Choi
Su-Mi
SM
Yoo
Jin-Hong
JH
Kim
Yoo-Jin
YJ
Min
Chang-Ki
CK
Lee
Seok
S
Kim
Dong-Wook
DW
Shin
Wan-Shik
WS
Kim
Chun-Choo
CC
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
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D000666:Amphotericin B