Cryptococcus neoformans fatal sepsis in a chronic lymphocytic leukemia patient treated with alemtuzumab: case report and review of the literature.
Cryptococcosis is a disseminated fungal disease typically associated with immunosuppression and characterized by high mortality rates. Cryptococcus neoformans has been reported to be isolated from blood cultures in around 20% of patients with cryptococcosis, and cryptococcemia has been correlated with poor prognosis. We report a case of fatal C. neoformans fungemia in a neutropenic patient with a history of chronic lymphocytic leukemia treated with alemtuzumab. The patient presented with loss of consciousness and died after 5 days of antifungal therapy with liposomal amphotericin B. The international literature regarding opportunistic infections after immunosuppressive therapy with alemtuzumab with particular attention on fungal infections has also been reviewed.
Bassetti
M
M
Infectious Diseases Division, S. Martino Hospital, University of Genoa, Genoa, Italy. matteo.bassetti@hsanmartino.it
Repetto
E
E
Mikulska
M
M
Miglino
M
M
Clavio
M
M
Gobbi
M
M
Righi
E
E
Viscoli
C
C
D000368:Aged; D000074323:Alemtuzumab; D000666:Amphotericin B / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000009:adverse effects*; D000935:Antifungal Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003453:Cryptococcosis / Q000150:complications* / Q000188:drug therapy; D003455:Cryptococcus neoformans; D017809:Fatal Outcome; D016469:Fungemia / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009503:Neutropenia / Q000139:chemically induced / Q000503:physiopathology; D009894:Opportunistic Infections / Q000150:complications*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000935:Antifungal Agents; D000970:Antineoplastic Agents; C068538:liposomal amphotericin B; D000074323:Alemtuzumab; D000666:Amphotericin B