Invasive Fungal Rhinosinusitis Due to Co-infection with Mucormycosis and Exserohilum rostratum in a Patient with Acute Lymphoblastic Leukemia.
Vera RadiciEolia BrissotSuzanne ChartierJuliette GuitardBettina FabianiMara MemoliAnne BanetLaurence HeubergerSimona LapusanSarah AtallahOllivier LegrandAlexis GenthonPublished in: Clinical hematology international (2022)
Invasive fungal infections remain an important cause of complication and morbidity in the management of acute leukemias. Here we report the case of a 27-year-old patient from French Polynesia who was diagnosed with Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia. After induction chemotherapy, she developed rhinosinusitis with extensive bone lysis. The context and clinical presentation quickly made us suspect an invasive mucormycosis infection. However, a multidisciplinary investigation including mass spectrometry techniques also revealed the presence of Exserohilum rostratum , a pathogen member of the genus Exserohilum that is ubiquitous in tropical and subtropical regions but rarely implicated in invasive sinusitis. Antifungal treatment combined with an early surgical approach resulted in a favorable clinical response.
Keyphrases
- acute lymphoblastic leukemia
- mass spectrometry
- allogeneic hematopoietic stem cell transplantation
- case report
- candida albicans
- liquid chromatography
- squamous cell carcinoma
- gene expression
- high resolution
- intensive care unit
- locally advanced
- radiation therapy
- acute myeloid leukemia
- quality improvement
- postmenopausal women
- single cell
- body composition
- drug induced
- dna methylation
- capillary electrophoresis
- ms ms
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation
- bone regeneration