An atypical case of fatal zygomycosis: simultaneous cutaneous and laryngeal infection in a patient with a non-neutropenic solid prostatic tumor.
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.
Johnson
Kristine E
KE
Division of Infectious Diseases, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21205-2100, USA. kjohns87@jhmi.edu
Leahy
Kevin
K
Owens
Christopher
C
Blankson
Joel N
JN
Merz
William G
WG
Goldstein
Bradley J
BJ
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*