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Development of a quantitative PCR detecting Cunninghamella bertholletiae to help in diagnosing this rare and aggressive mucormycosis

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Abstract

Mucormycosis is an invasive mold infection, frequently fatal in immunocompromised patients. We report the case of a patient with chronic lymphocytic leukemia admitted to the hematology unit for febrile aplasia. Pulmonary lesions suggesting a fungal infection expanded/increased despite a combination of posaconazole and liposomal amphotericin B. The fungal biomarkers performed repeatedly were negative. At D65 after chemotherapy a bronchial biopsy was positive for Cunninghamella bertholletiae. The patient died despite appropriate antifungal management. A qPCR targeting Cunninghamella was developed a posteriori, and a retrospective analysis showed that a sample was positive more than 30 days before culture-based identification could be made.

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Acknowledgements

This work was supported by a grant from the French Ministry of Health (PHRC (Projet Hospitalier de Recherche Clinique) national-ModiMucor 2014-A00580-47). We thank the National Reference Center of Invasive Mycosis and Antifungal Molecular Mycology Unit (CNRMA), Pasteur Institute, Paris, France. We thank Pamela Albert for her editorial assistance.

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Correspondence to Anne-Pauline Bellanger.

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Bellanger, AP., Berceanu, A., Rocchi, S. et al. Development of a quantitative PCR detecting Cunninghamella bertholletiae to help in diagnosing this rare and aggressive mucormycosis. Bone Marrow Transplant 53, 1180–1183 (2018). https://doi.org/10.1038/s41409-018-0194-5

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