TY - JOUR
T1 - Therapeutic challenges of hepatic mucormycosis in hematologic malignancy
T2 - A case report and review of the literature
AU - Bernardo, Raffaele M.
AU - Gurung, Ananta
AU - Jain, Dhanpat
AU - Malinis, Maricar F.
N1 - Publisher Copyright:
© Am J Case Rep.
PY - 2016/7/13
Y1 - 2016/7/13
N2 - Objective: Rare disease Background: The clinical presentation of mucormycosis can vary widely based on various host factors. Among malignancyand bone marrow transplant-associated infections, the lungs are the most common site of infection. Involvement of the gastrointestinal tract is less frequently encountered. The clinical presentation is often nonspecific, and cultures typically yield no growth, making the diagnosis challenging. Case Report: We present a case of isolated hepatic mucormycosis in the setting of neutropenic fever and abdominal pain following induction chemotherapy for the treatment of acute myeloid leukemia. The patient was treated with combination antifungal therapy with amphotericin and posaconazole without surgical resection, given the presence of multiple liver lesions. After a prolonged course of dual antifungal therapy, the size of her liver lesions improved. Unfortunately, her lymphoproliferative disorder proved fatal, following approximately 13 months of antifungal therapy. Conclusions: Among patient with mucormycosis, mortality remains high, especially in the setting of gastrointestinal involvement. Although surgical resection along with dual antifungal therapy can improve outcomes, the high mortality rate necessitates further investigation into improved diagnostic and treatment strategies including optimal antifungal therapy.
AB - Objective: Rare disease Background: The clinical presentation of mucormycosis can vary widely based on various host factors. Among malignancyand bone marrow transplant-associated infections, the lungs are the most common site of infection. Involvement of the gastrointestinal tract is less frequently encountered. The clinical presentation is often nonspecific, and cultures typically yield no growth, making the diagnosis challenging. Case Report: We present a case of isolated hepatic mucormycosis in the setting of neutropenic fever and abdominal pain following induction chemotherapy for the treatment of acute myeloid leukemia. The patient was treated with combination antifungal therapy with amphotericin and posaconazole without surgical resection, given the presence of multiple liver lesions. After a prolonged course of dual antifungal therapy, the size of her liver lesions improved. Unfortunately, her lymphoproliferative disorder proved fatal, following approximately 13 months of antifungal therapy. Conclusions: Among patient with mucormycosis, mortality remains high, especially in the setting of gastrointestinal involvement. Although surgical resection along with dual antifungal therapy can improve outcomes, the high mortality rate necessitates further investigation into improved diagnostic and treatment strategies including optimal antifungal therapy.
KW - Amphotericin B
KW - Antifungal Agents
KW - Leukemia, Myeloid, Acute
KW - Liver Abscess
KW - Mucorales
KW - Mucormycosis
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U2 - 10.12659/AJCR.898480
DO - 10.12659/AJCR.898480
M3 - Article
C2 - 27406045
AN - SCOPUS:84984996889
SN - 1941-5923
VL - 17
SP - 484
EP - 489
JO - American Journal of Case Reports
JF - American Journal of Case Reports
ER -