title: An atypical case of fatal zygomycosis: simultaneous cutaneous and laryngeal infection in a patient with a non-neutropenic solid prostatic tumor.
abstract: We describe what we believe is the first reported case of simultaneous highly invasive cutaneous and laryngopharyngeal zygomycosis in a non-neutropenic, nondiabetic but immunosuppressed patient with prostate cancer. An invasive fungal process was not suspected until late in the patient's hospital course; when it was, a tracheotomy and direct laryngoscopic biopsies were performed. Unresectable invasive zygomycosis with Rhizopus rhizopodiformis was diagnosed. The patient was managed with liposomal amphotericin B initially and later with palliative medical therapy until he died. This case emphasizes the need for a rapid and specific diagnosis with timely introduction of appropriate antifungal management, particularly now that voriconazole is frequently used as empiric prophylaxis against aspergillosis in high-risk patients.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21205-2100, USA. kjohns87@jhmi.edu
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Johnson
authors.forename: Kevin
authors.initials: K
authors.lastname: Leahy
authors.forename: Christopher
authors.initials: C
authors.lastname: Owens
authors.forename: Joel N
authors.initials: JN
authors.lastname: Blankson
authors.forename: William G
authors.initials: WG
authors.lastname: Merz
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Goldstein
mesh_terms: D000368:Aged; D003881:Dermatomycoses / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D008297:Male; D009091:Mucormycosis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D010608:Pharyngeal Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D011471:Prostatic Neoplasms / Q000628:therapy*; D012233:Rhizopus / Q000302:isolation & purification*