[Fatal zygomycosis caused by Mucor indicus after haplo-identical stem cell transplantation].
Rinsho Ketsueki
; 54(3): 311-5, 2013 Mar.
Article
em Ja
| MEDLINE
| ID: mdl-23676649
ABSTRACT
A 62-year-old woman with acute lymphoblastic leukemia in first complete remission was treated with unrelated cord blood transplantation, but exhibited primary graft failure. She then underwent HLA-haploidentical peripheral blood stem cell transplantation from her daughter. The conditioning regimen consisted of fludarabine 30 mg/m(2)/day for 6 days, intravenous busulfan 3.2 mg/kg/day for 2 days, and thymoglobulin 1 mg/kg/day for 2 days. Voriconazole was administered to prevent fungal infections. The patient achieved prompt hematopoietic recovery. Fever was observed 21 days after the second transplant, followed by sigmoid colon perforation and a liver space occupying lesion (SOL). A filamentous fungus was detected in a percutaneous biopsy of the liver SOL. In spite of changing the antifungal drug from voriconazole to liposomal amphotericin B, the patient died on day 41. The fungus was identified as Mucor indicus, a type of zygomycete. Although Mucor indicus inhabits soil, an infectious disease is extremely rare, and breakthrough infection after voriconazole prophylaxis had not been reported until now. It is mandatory to consider preventive antifungal treatment for drug-resistant fungal infectious diseases in patients after neutrophilic recovery with a strongly immunocompromised state after a HLA-haploidentical transplant.
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Base de dados:
MEDLINE
Assunto principal:
Vidarabina
/
Transplante de Células-Tronco Hematopoéticas
/
Zigomicose
/
Doença Enxerto-Hospedeiro
/
Mucor
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Middle aged
Idioma:
Ja
Revista:
Rinsho Ketsueki
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Japão