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Scientific article
Case report
English

Disseminated Rhizopus microsporus infection cured by salvage allogeneic hematopoietic stem cell transplantation, antifungal combination therapy, and surgical resection

Contributors

Lebeau, O.; Van Delden, Christian; Garbino, Jorge; Robert, John; Lamoth, F.; Passweg, Jakob; Chalandon, Yves

Published in

Transplant infectious disease, vol. 12, no. 3, p. 269-272

Publication date

2010

Abstract

Invasive Zygomycetes infection complicating prolonged neutropenia is associated with high mortality in the absence of immune recovery. We report a patient who developed disseminated zygomycosis due to Rhizopus microsporus during induction chemotherapy for acute myeloid leukemia. Rescue allogeneic hematopoietic stem cell transplantation (allo-HSCT) was performed as her only chance of cure of this infection and to treat refractory leukemia. Posaconazole combined with liposomal amphotericin B contained the zygomycosis during prolonged neutropenia due to allo-HSCT followed by intense immunosuppression for grade IV acute graft-versus-host disease. Surgical removal of all infected sites after immune recovery, with prolonged posaconazole treatment, ultimately cured the infection. New combination antifungal therapies might sufficiently control disseminated zygomycosis to allow allo-HSCT to be performed, assuring life-saving immune recovery. Surgery appears to be necessary for definite cure of these infections.

Keywords

  • Amphotericin B/therapeutic use
  • Antifungal Agents/ therapeutic use
  • Drug Therapy, Combination
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Leukemia, Myeloid, Acute/complications/drug therapy
  • Middle Aged
  • Mucormycosis/ drug therapy/immunology/microbiology/ surgery
  • Rhizopus/classification/ drug effects/isolation & purification
  • Salvage Therapy
  • Transplantation, Homologous
  • Treatment Outcome
  • Triazoles/therapeutic use

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

LEBEAU, O. et al. Disseminated Rhizopus microsporus infection cured by salvage allogeneic hematopoietic stem cell transplantation, antifungal combination therapy, and surgical resection. In: Transplant infectious disease, 2010, vol. 12, n° 3, p. 269–272. doi: 10.1111/j.1399-3062.2009.00484.x

Main files (1)

Article

Identifiers

Additional URL for this publication

http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1399-3062

Journal ISSN

1398-2273
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Technical informations

Creation

23/05/2012 08:49:57

First validation

23/05/2012 08:49:57

Update

14/03/2023 17:34:06

Status update

14/03/2023 17:34:06

Last indexation

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