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.
Infectious Diseases Division, S. Martino Hospital, University of Genoa, Genoa, Italy. matteo.bassetti@hsanmartino.it
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M
Bassetti
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Repetto
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Mikulska
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Miglino
M
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Clavio
M
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Gobbi
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Righi
C
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Viscoli
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