Invasive Fungal Rhinosinusitis Due to Co-infection with Mucormycosis and Exserohilum rostratum in a Patient with Acute Lymphoblastic Leukemia.

Clinical Hematology International Pub Date : 2022-06-13 eCollection Date: 2022-06-01 DOI:10.1007/s44228-022-00009-3

Vera Radici, Eolia Brissot, Suzanne Chartier, Juliette Guitard, Bettina Fabiani, Mara Memoli, Anne Banet, Laurence Heuberger, Simona Lapusan, Sarah Atallah, Ollivier Legrand, Alexis Genthon

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Abstract

Invasive fungal infections remain an important cause of complication and morbidity in the management of acute leukemias. Here we report the case of a 27-year-old patient from French Polynesia who was diagnosed with Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia. After induction chemotherapy, she developed rhinosinusitis with extensive bone lysis. The context and clinical presentation quickly made us suspect an invasive mucormycosis infection. However, a multidisciplinary investigation including mass spectrometry techniques also revealed the presence of Exserohilum rostratum, a pathogen member of the genus Exserohilum that is ubiquitous in tropical and subtropical regions but rarely implicated in invasive sinusitis. Antifungal treatment combined with an early surgical approach resulted in a favorable clinical response.

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急性淋巴细胞白血病合并毛霉病和喙状芽孢杆菌感染致侵袭性真菌性鼻窦炎1例。

侵袭性真菌感染仍然是急性白血病治疗中并发症和发病率的重要原因。在这里，我们报告一个27岁的病人从法属波利尼西亚谁被诊断为费城染色体阴性b细胞急性淋巴细胞白血病。诱导化疗后，患者出现鼻窦炎伴广泛骨溶解。背景和临床表现很快使我们怀疑是侵袭性毛霉菌感染。然而，一项包括质谱技术在内的多学科研究也发现了枯茎芽孢菌(exserhilum rostratum)的存在，这是枯茎芽孢菌属的一种病原体，普遍存在于热带和亚热带地区，但很少涉及侵入性鼻窦炎。抗真菌治疗结合早期手术方法导致良好的临床反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Clinical Hematology International

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