title: Cunninghamella bertholletiae Infection in a HLA-Haploidentical Hematopoietic Stem Cell Transplant Recipient with Graft Failure: Case Report and Review of the Literature.
abstract: Cunninghamella bertholletiae as a rare cause of mucormycosis has been described almost exclusively in immunosuppressed patients such as hematopoietic stem cell transplant (HSCT) recipients. The infection is associated with high rates of mortality despite aggressive treatment. We describe a 40-year-old male with HLA-haploidentical HSCT developed fungal pneumonitis caused by C. bertholletiae complicated by graft failure and prolonged neutropenia. The patient died 102 days after HSCT despite early use of posaconazole and amphotericin B, which are believed to be the two most effective antifungal antibiotics against C. bertholletiae. The case highlights extreme unfavorable outcome in C. bertholletiae infection and neutropenia as a major risk factor.
authors.affiliation: Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China.|Department of Hematology, Jinhua Central Hospital, No. 351 Mingyue Road, Jinhua, 321000, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Luo
authors.affiliation: Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China.
authors.forename: Jiasheng
authors.initials: J
authors.lastname: Wang
authors.affiliation: Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China.
authors.forename: Yongxian
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China.
authors.forename: Yamin
authors.initials: Y
authors.lastname: Tan
authors.affiliation: Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China.
authors.forename: Aiyun
authors.initials: A
authors.lastname: Jin
authors.affiliation: Department of Hematology, Jinhua Central Hospital, No. 351 Mingyue Road, Jinhua, 321000, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wei
authors.affiliation: Department of Hematology, Jinhua Central Hospital, No. 351 Mingyue Road, Jinhua, 321000, China.
authors.forename: Huixian
authors.initials: H
authors.lastname: Hu
authors.affiliation: Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China. huanghe@zju.edu.cn.
authors.forename: He
authors.initials: H
authors.lastname: Huang
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D020093:Cunninghamella / Q000145:classification* / Q000302:isolation & purification*; D017809:Fatal Outcome; D006084:Graft Rejection / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D008853:Microscopy; D009091:Mucormycosis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D013909:Thorax / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D066027:Transplant Recipients; D014230:Triazoles / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D000666:Amphotericin B
keywords: Cunninghamella; Fungal pneumonia; Mucormycosis; Stem cell transplantation