title: A long-term survivor of disseminated Aspergillus and mucorales infection: an instructive case.
abstract: Invasive fungal infections remain major causes of infection-related mortality in hematopoietic stem cell transplantation (HSCT) patients. Mixed infections and multiple organ involvement have been reported in these patients. Here, we report a case of mixed Aspergillus and Mucorales infection involving the lungs, brain, spleen and bone in a HSCT patient with relapsed acute myeloid leukemia, who finally improved with triple antifungal therapy and neurosurgical evacuation of brain abscesses. She was put on lifelong secondary prophylaxis with posaconazole with excellent compliance and no sign of toxicity despite over 10 years of drug administration. Serial galactomannan measurements and positron emission tomography/computed tomography were used and were helpful for disease activity monitoring. This is an instructive case of long-term survival after a severe combined mould infection.
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, Unit 1460, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
authors.forename: Setareh
authors.initials: S
authors.lastname: Davoudi
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Fuller
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Kontoyiannis
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D001230:Aspergillus / Q000302:isolation & purification*; D001853:Bone Marrow / Q000382:microbiology / Q000473:pathology; D001921:Brain / Q000382:microbiology / Q000473:pathology; D018890:Chemoprevention / Q000379:methods; D060085:Coinfection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D016903:Drug Monitoring; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008351:Mannans / Q000032:analysis; D009090:Mucorales / Q000302:isolation & purification*; D009091:Mucormycosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013154:Spleen / Q000382:microbiology / Q000473:pathology; D017741:Survivors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D008351:Mannans; C012990:galactomannan; D005690:Galactose
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