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Cunninghamella bertholletiae Infection in a HLA-Haploidentical Hematopoietic Stem Cell Transplant Recipient with Graft Failure: Case Report and Review of the Literature

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Abstract

Cunninghamella bertholletiae as a rare cause of mucormycosis has been described almost exclusively in immunosuppressed patients such as hematopoietic stem cell transplant (HSCT) recipients. The infection is associated with high rates of mortality despite aggressive treatment. We describe a 40-year-old male with HLA-haploidentical HSCT developed fungal pneumonitis caused by C. bertholletiae complicated by graft failure and prolonged neutropenia. The patient died 102 days after HSCT despite early use of posaconazole and amphotericin B, which are believed to be the two most effective antifungal antibiotics against C. bertholletiae. The case highlights extreme unfavorable outcome in C. bertholletiae infection and neutropenia as a major risk factor.

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Acknowledgments

This work was jointly supported by Grants from Zhejiang Provincial Natural Science Foundation of China (LY14H080002, Y2110183), the National Natural Science Foundation of China (81470341, 81500157), Zhejiang Medical Technology and Education (201476288, 2014KYA066) and Jinhua Administration of Science and Technology (2014-3-006).

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    Authors and Affiliations

    1. Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, China

      Chao Luo, Jiasheng Wang, Yongxian Hu, Yi Luo, Yamin Tan, Aiyun Jin & He Huang

    2. Department of Hematology, Jinhua Central Hospital, No. 351 Mingyue Road, Jinhua, 321000, China

      Chao Luo, Bin Wei & Huixian Hu

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    1. Chao Luo
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    2. Jiasheng Wang
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    Correspondence to He Huang.

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    Chao Luo and Jiasheng Wang have contributed equally to this work.

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    Luo, C., Wang, J., Hu, Y. et al. Cunninghamella bertholletiae Infection in a HLA-Haploidentical Hematopoietic Stem Cell Transplant Recipient with Graft Failure: Case Report and Review of the Literature. Mycopathologia 181, 753–758 (2016). https://doi.org/10.1007/s11046-016-0030-7

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