Skip to main content

Advertisement

Log in

Zygomycosis Presenting a Major Clinical Challenge: Case Report on Rhizomucor pusillus Infection in a Stem-Cell-Transplant Recipient

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

Zygomycoses are opportunistic infections caused by the Mucorales fungi. They are typically seen in immunosuppressed patients. The incidence of zygomycosis cases seems to be increasing. We report on zygomycosis in a pediatric, female stem-cell-transplant recipient. This case report underlines the difficulty of taking care of patients with zygomycosis. In fungal infections of immunosuppressive patients on broad-coverage antibiotics, foci of skin necrosis are unique and typical for zygomycoses, and may be helpful in this challenging diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J Jr, Ibrahim AS. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis. 2009;48:1743–51.

    Article  PubMed  CAS  Google Scholar 

  2. Singh N, Aguado JM, Bonatti H, et al. Zygomycosis in solid organ transplant recipients: a prospective, matched case-control study to assess risks for disease and outcome. J Infect Dis. 2009;200:1002–11.

    Article  PubMed  Google Scholar 

  3. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41:634–53.

    Article  PubMed  Google Scholar 

  4. Dehority W, Willert J, Pong A. Zygomycetes infections in pediatric hematology oncology patients: a case series and review of the literature. J Pediatr Hematol Oncol. 2009;31:911–9.

    Article  PubMed  Google Scholar 

  5. Abuali MM, Posada R, Del Toro G, et al. Rhizomucor variabilis var. regularior and Hormographiella aspergillata infections in a leukemic bone marrow transplant recipient with refractory neutropenia. J Clin Microbiol. 2009;47:4176–9.

    Article  PubMed  Google Scholar 

  6. Sorensen J, Becker M, Porto L, et al. Rhinocerebral zygomycosis in a young girl undergoing allogeneic stem cell transplantation for severe aplastic anaemia. Mycoses. 2006;49(Suppl 1):31–6.

    Article  PubMed  Google Scholar 

  7. Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis. 2008;47:503–9.

    Article  PubMed  Google Scholar 

  8. Partridge-Hinckley K, Liddell GM, Almyroudis NG, Segal BH. Infection control measures to prevent invasive mould diseases in hematopoietic stem cell transplant recipients. Mycopathologia. 2009;168:329–37.

    Article  PubMed  Google Scholar 

  9. Trifilio S, Singhal S, Williams S, et al. Breakthrough fungal infections after allogeneic hematopoietic stem cell transplantation in patients on prophylactic voriconazole. Bone Marrow Transplant. 2007;40:451–6.

    Article  PubMed  CAS  Google Scholar 

  10. Marty FM, Cosimi LA, Baden LR. Breakthrough zygomycosis after voriconazole treatment in recipients of hematopoietic stem-cell transplants. N Engl J Med. 2004;350:950–2.

    Article  PubMed  CAS  Google Scholar 

  11. Perkhofer S, Locher M, Cuenca-Estrella M, et al. Posaconazole enhances the activity of amphotericin B against hyphae of zygomycetes in vitro. Antimicrob Agents Chemother. 2008;52:2636–8.

    Article  PubMed  CAS  Google Scholar 

  12. Antoniadou A. Outbreaks of zygomycosis in hospitals. Clin Microbiol Infect. 2009;15(Suppl 5):55–9.

    Article  PubMed  Google Scholar 

  13. Mousset S, Bug G, Heinz WJ, Tintelnot K, Rickerts V. Breakthrough zygomycosis on posaconazole prophylaxis after allogeneic stem cell transplantation. Transpl Infect Dis. 2010;12:261–4.

    Article  PubMed  CAS  Google Scholar 

  14. Lekakis LJ, Lawson A, Prante J, et al. Fatal rhizopus pneumonia in allogeneic stem cell transplant patients despite posaconazole prophylaxis: two cases and review of the literature. Biol Blood Marrow Transpl. 2009;15:991–5.

    Article  Google Scholar 

  15. Zaoutis TE, Roilides E, Chiou CC, et al. Zygomycosis in children: a systematic review and analysis of reported cases. Pediatr Infect Dis J. 2007;26:723–7.

    Article  PubMed  Google Scholar 

  16. Roilides E, Zaoutis TE, Walsh TJ. Invasive zygomycosis in neonates and children. Clin Microbiol Infect. 2009;15(Suppl 5):50–4.

    Article  PubMed  Google Scholar 

  17. Bitar D, Van Cauteren D, Lanternier F, et al. Increasing incidence of zygomycosis (mucormycosis), France, 1997–2006. Emerg Infect Dis. 2009;15:1395–401.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sanna-Maria Kivivuori.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kivivuori, SM., Karikoski, R., Koukila-Kähkölä, P. et al. Zygomycosis Presenting a Major Clinical Challenge: Case Report on Rhizomucor pusillus Infection in a Stem-Cell-Transplant Recipient. Mycopathologia 172, 241–245 (2011). https://doi.org/10.1007/s11046-011-9424-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-011-9424-8

Keywords

Navigation