[Invasive zygomycosis in patients treated for haematological malignancies].
A 52-year-old man underwent haematopoietic stem-cell transplant for myelodysplastic syndrome; after treatment with voriconazole for invasive aspergillosis, he was diagnosed with invasive zygomycosis caused by Rhizopus microsporus. He died despite treatment with intravenous liposomal amphotericin B and posaconazole. A 5-year-old boy with acute lymphatic leukaemia was diagnosed with invasive zygomycosis at autopsy. In a third case, a 16-year-old boy with acute myeloid leukaemia received repeated courses of empiric antifungal therapy, although the presence of an invasive fungal infection was not demonstrated. The patient died, and disseminated invasive zygomycosis caused by Rhizomucor pusillus was found at autopsy. Invasive infections by Zygomycetes are difficult to diagnose and are associated with a high mortality rate. The incidence of invasive zygomycosis appears to be increasing. Therefore, awareness of this type of invasive fungal infection is warranted. Lipid formulations ofamphotericin B remain the first choice for therapy.
Verweij
P E
PE
Universitair Medisch Centrum St Radboud, Nijmegen. p.verweij@mmb.umcn.nl
van der Velden
W J F M
WJ
Donnelly
J P
JP
Blijlevens
N M A
NM
Warris
A
A
D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D017809:Fatal Outcome; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D016377:Organ Transplantation; D012233:Rhizopus / Q000187:drug effects / Q000302:isolation & purification*; D014181:Transplantation Immunology; D014230:Triazoles / Q000627:therapeutic use; D020096:Zygomycosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*
D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B