A case of Cunninghamella bertholettiae rhino-cerebral infection in a leukaemic patient and review of recent published studies.
Cunninghamella bertholletiae infection occurs most frequently in neutropenic patients affected by haematological malignancies, is associated with an unfavourable outcome. We report a case of rhino-mastoidal fungal infection in a leukaemic patient. Bioptical tissue cultures yield the isolation of a mould with typical properties of Cunninghamella species. Liposomal amphotericin B (L-Amb) therapy combined with surgical intervention brought the lesion to recovery. Nevertheless, the patient died 14 days after bone marrow transplantation (BMT) from bacterial sepsis. Mastoiditis was documented at CT-scan. The conditioning regimen probably caused the reactivation of the Cunninghamella infection that led to the patient's fatal outcome; fungal hyphae were detected after autopsy of brain and lung tissue.
Righi
E
E
Division of Infectious Diseases, S. Martino Hospital, University of Genoa School of Medicine, Genoa, Italy. elda.righi@libero.it
Giacomazzi
C G
CG
Lindstrom
V
V
Albarello
A
A
Soro
O
O
Miglino
M
M
Perotti
M
M
Varnier
O E
OE
Gobbi
M
M
Viscoli
C
C
Bassetti
M
M
D000666:Amphotericin B / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D020093:Cunninghamella / Q000187:drug effects* / Q000472:pathogenicity; D006801:Humans; D016867:Immunocompromised Host; D007951:Leukemia, Myeloid / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000382:microbiology / Q000601:surgery; D009091:Mucormycosis / Q000209:etiology* / Q000378:metabolism; D009894:Opportunistic Infections / Q000209:etiology / Q000378:metabolism
D000666:Amphotericin B