Serial monitoring of Mucorales DNA load in serum samples of a patient with disseminated mucormycosis after allogeneic bone marrow transplantation.
Mucormycosis is a fatal complication in immunocompromised patients, and is additionally difficult to diagnose due to the lack of useful serum biomarkers. Using a quantitative PCR approach, we retrospectively analyzed Mucorales DNA load in sera collected serially from a 3-year-old patient with chronic granulomatous disease, who died of multi-organ failure probably due to dissemination of Rhizomucor pusillus, which was detected from necropsy specimens. Mucorales DNA load was below the detection limit on days 9, 2, and 4 after unrelated bone marrow transplantation. Rhizomucor DNA was first detected on day 14 (1.6 × 10(3) copies/mL), and subsequently fluctuated between 1.3 × 10(3) and 37.2 × 10(3) copies/mL until day 43. Rhizomucor achieved a peak value of 940.0 × 10(3) copies/mL on day 48 the day before death. The detection or fluctuation of Rhizomucor DNA appeared to be associated with corticosteroid dosages or C-reactive protein levels. This specific, noninvasive, and highly quantitative assay may be useful for the early diagnosis of mucormycosis and prediction of disease progression.
Department of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
Tomonari
T
Shigemura
Yozo
Y
Nakazawa
Kazuyuki
K
Matsuda
Kenji
K
Sano
Takashi
T
Yaguchi
Mitsuo
M
Motobayashi
Shoji
S
Saito
Shunsuke
S
Noda
Norimoto
N
Kobayashi
Kazunaga
K
Agematsu
Takayuki
T
Honda
Kenichi
K
Koike
D016026:Bone Marrow Transplantation; D002097:C-Reactive Protein / Q000378:metabolism; D002675:Child, Preschool; D004271:DNA, Fungal / Q000097:blood*; D017809:Fatal Outcome; D006105:Granulomatous Disease, Chronic / Q000276:immunology* / Q000382:microbiology / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D009091:Mucormycosis / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D020103:Rhizomucor / Q000472:pathogenicity / Q000502:physiology; D014184:Transplantation, Homologous
D004271:DNA, Fungal; D007166:Immunosuppressive Agents; D002097:C-Reactive Protein