Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia
Introduction. Invasive fungal infection is among the leading causes of morbidity, mortality, and economic burden for patients with acute leukemia after induction of chemotherapy. In the past few decades, the incidence of invasive fungal infection has increased dramatically. Its management h...
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doaj-4e88f1e1db1f4afe9c9b101c91c268c42021-01-02T14:56:17ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792406-08952016-01-0114411-1265766010.2298/SARH1612657C0370-81791612657CMucormycosis of the paranasal sinuses in a patient with acute myeloid leukemiaČolović Nataša0Arsić-Arsenijević Valentina1Barać Aleksandra2Suvajdžić Nada3Leković Danijela4Tomin Dragica5Clinical Center of Serbia, Clinic for Hematology, Belgrade + School of Medicine, BelgradeSchool of Medicine, Institute of Microbiology and Immunology, BelgradeSchool of Medicine, Institute of Microbiology and Immunology, BelgradeClinical Center of Serbia, Clinic for Hematology, Belgrade + School of Medicine, BelgradeClinical Center of Serbia, Clinic for Hematology, Belgrade + School of Medicine, BelgradeClinical Center of Serbia, Clinic for Hematology, Belgrade + School of Medicine, BelgradeIntroduction. Invasive fungal infection is among the leading causes of morbidity, mortality, and economic burden for patients with acute leukemia after induction of chemotherapy. In the past few decades, the incidence of invasive fungal infection has increased dramatically. Its management has been further complicated by the increasing frequency of infection by non-Aspergillus molds (e.g. Mucorales). Neutropenic patients are at a high risk of developing an invasive mucormycosis with fulminant course and high mortality rate (35-100%). Case Outline. We are presenting the case of a 72-year-old male with an acute monoblastic leukemia. The patient was treated during five days with hydroxycarbamide 2 × 500 mg/day, followed by cytarabine 2 × 20 mg/sc over the next 10 days. He developed febrile neutropenia, headache, and edema of the right orbital region of the face. Computed tomography of the sinuses revealed shadow in sinuses with thickening of mucosa of the right paranasal sinuses. Lavage and aspirate from the sinuses revealed Rhizopus oryzae. Mucormycosis was successfully treated with amphotericin B (5 mg/kg/day) followed by ketoconazole (400 mg/day). Two months later the patient died from primary disease. Conclusion. In patients with acute leukemia who developed aplasia, febrile neutropenia, and pain in paranasal sinuses, fungal infection should be taken into consideration. New and non-invasive methods for taking samples from sinuses should be standardized in order to establish an early and accurate diagnosis of mucormycosis with the source in paranasal sinuses, and to start early treatment by a proper antifungal drug. Clear communication between physician and mycologist is critical to ensure proper and timely sampling of lavage and aspirate from sinuses and correct specimen processing when mucormycosis is suspected clinically. [Projekat Ministartsva nauke Republike Srbije, br. OI 175034]http://www.doiserbia.nb.rs/img/doi/0370-8179/2016/0370-81791612657C.pdfacute leukemianeutropeniamucormycosisparanasal sinusesinvasive fungal infection |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Čolović Nataša Arsić-Arsenijević Valentina Barać Aleksandra Suvajdžić Nada Leković Danijela Tomin Dragica |
spellingShingle |
Čolović Nataša Arsić-Arsenijević Valentina Barać Aleksandra Suvajdžić Nada Leković Danijela Tomin Dragica Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia Srpski Arhiv za Celokupno Lekarstvo acute leukemia neutropenia mucormycosis paranasal sinuses invasive fungal infection |
author_facet |
Čolović Nataša Arsić-Arsenijević Valentina Barać Aleksandra Suvajdžić Nada Leković Danijela Tomin Dragica |
author_sort |
Čolović Nataša |
title |
Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia |
title_short |
Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia |
title_full |
Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia |
title_fullStr |
Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia |
title_full_unstemmed |
Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia |
title_sort |
mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia |
publisher |
Serbian Medical Society |
series |
Srpski Arhiv za Celokupno Lekarstvo |
issn |
0370-8179 2406-0895 |
publishDate |
2016-01-01 |
description |
Introduction. Invasive fungal infection is among the leading causes of
morbidity, mortality, and economic burden for patients with acute leukemia
after induction of chemotherapy. In the past few decades, the incidence of
invasive fungal infection has increased dramatically. Its management has been
further complicated by the increasing frequency of infection by
non-Aspergillus molds (e.g. Mucorales). Neutropenic patients are at a high
risk of developing an invasive mucormycosis with fulminant course and high
mortality rate (35-100%). Case Outline. We are presenting the case of a
72-year-old male with an acute monoblastic leukemia. The patient was treated
during five days with hydroxycarbamide 2 × 500 mg/day, followed by cytarabine
2 × 20 mg/sc over the next 10 days. He developed febrile neutropenia,
headache, and edema of the right orbital region of the face. Computed
tomography of the sinuses revealed shadow in sinuses with thickening of
mucosa of the right paranasal sinuses. Lavage and aspirate from the sinuses
revealed Rhizopus oryzae. Mucormycosis was successfully treated with
amphotericin B (5 mg/kg/day) followed by ketoconazole (400 mg/day). Two
months later the patient died from primary disease. Conclusion. In patients
with acute leukemia who developed aplasia, febrile neutropenia, and pain in
paranasal sinuses, fungal infection should be taken into consideration. New
and non-invasive methods for taking samples from sinuses should be
standardized in order to establish an early and accurate diagnosis of
mucormycosis with the source in paranasal sinuses, and to start early
treatment by a proper antifungal drug. Clear communication between physician
and mycologist is critical to ensure proper and timely sampling of lavage and
aspirate from sinuses and correct specimen processing when mucormycosis is
suspected clinically. [Projekat Ministartsva nauke Republike Srbije, br. OI
175034] |
topic |
acute leukemia neutropenia mucormycosis paranasal sinuses invasive fungal infection |
url |
http://www.doiserbia.nb.rs/img/doi/0370-8179/2016/0370-81791612657C.pdf |
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