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Title

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

Authors
Lebeau, O.
Lamoth, F.
Published in Transplant Infectious Disease. 2010, vol. 12, no. 3, p. 269-272
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 useAntifungal Agents/ therapeutic useDrug Therapy, CombinationFemaleHematopoietic Stem Cell TransplantationHumansLeukemia, Myeloid, Acute/complications/drug therapyMiddle AgedMucormycosis/ drug therapy/immunology/microbiology/ surgeryRhizopus/classification/ drug effects/isolation & purificationSalvage TherapyTransplantation, HomologousTreatment OutcomeTriazoles/therapeutic use
Identifiers
PMID: 20163567
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Research group Chirurgie thoracique et chirurgie endocrinologique (573)
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(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. https://archive-ouverte.unige.ch/unige:21081

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Deposited on : 2012-05-23

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