title: Fatal Breakthrough Mucormycosis in an Acute Myelogenous Leukemia Patient while on Posaconazole Prophylaxis.
abstract: Posaconazole is a new oral triazole with broad-spectrum antifungal activity. Posaconazole has also shown a significant advantage of preventing invasive fungal infection compared to fluconazole or itraconazole in patients with prolonged neutropenia. Indeed, posaconazole has been commonly used for antifungal prophylaxis in patients undergoing remission induction chemotherapy for acute myelogenous leukemia or myelodysplastic syndrome. We experienced a case of fatal mucormycosis despite posaconazole prophylaxis. To our knowledge, this is the first reported case of fatal breakthrough mucormycosis in a patient receiving posaconazole prophylaxis during remission induction chemotherapy in Korea. This case demonstrated that breakthrough fungal infection can occurs in patients receiving posaconazole prophylaxis because of its limited activity against some mucorales.
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hyun Seon
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Myoung Nam
authors.initials: MN
authors.lastname: Bae
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jihye
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Yoo
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kwan Yong
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Dong-Gun
authors.identifier: 0000-0003-4655-0641
authors.initials: DG
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hee-Je
authors.initials: HJ
authors.lastname: Kim
keywords: Leukemia, Myeloid, Acute; Mucormycosis; Posaconazole; Prophylaxis
references.citation: Infect Chemother. 2013 Sep;45(3):292-8
references.pmid: 24396630
references.citation: Clin Infect Dis. 2005 Jun 15;40(12):1762-9
references.pmid: 15909264
references.citation: N Engl J Med. 2007 Jan 25;356(4):348-59
references.pmid: 17251531
references.citation: J Clin Microbiol. 2010 Jun;48(6):2043-6
references.pmid: 20375233
references.citation: Bone Marrow Transplant. 2008 Oct;42(8):551-2
references.pmid: 18622416
references.citation: Clin Microbiol Infect. 2009 Oct;15 Suppl 5:66-70
references.pmid: 19754761
references.citation: Ann Pharmacother. 2008 Oct;42(10):1429-38
references.pmid: 18713852
references.citation: Biol Blood Marrow Transplant. 2009 Aug;15(8):991-5
references.pmid: 19589489
references.citation: Pharmacotherapy. 2007 Dec;27(12):1627-36
references.pmid: 18041883
references.citation: Clin Infect Dis. 2007 Jan 1;44(1):2-12
references.pmid: 17143808
references.citation: Antimicrob Agents Chemother. 2007 Jul;51(7):2587-90
references.pmid: 17452481
references.citation: Clin Infect Dis. 2011 Feb 15;52(4):e56-93
references.pmid: 21258094
references.citation: Haematologica. 2013 Apr;98(4):492-504
references.pmid: 22983580
references.citation: Clin Infect Dis. 2008 Aug 15;47(4):503-9
references.pmid: 18611163
references.citation: Korean J Intern Med. 2011 Jun;26(2):220-52
references.pmid: 21716917
references.citation: Drugs. 2008;68(7):993-1016
references.pmid: 18457464
references.citation: Cancer. 2002 Jun 15;94(12):3230-46
references.pmid: 12115356
references.citation: Ann Thorac Surg. 1994 Apr;57(4):1044-50
references.pmid: 8166512
references.citation: Antimicrob Agents Chemother. 2009 Dec;53(12):5224-9
references.pmid: 19752284
references.citation: Transpl Infect Dis. 2010 Jun;12(3):261-4
references.pmid: 19954497