Introduction: Mucormycosis, also known as zygomycosis, is a rare opportunistic fungal infection that mostly affect immunocompromised patients. main clinical presentation is pulmonary infection that is often indistinguishable from pulmonary Aspergillosis but doesn’t respond to tretment with voriconazole. Case report: The authors report the case of a 12 years old boy who underwent bone marrow transplantation for aplastic anemia, that since 6th day post transplantation showed an x-ray opacity in the upper lobe of the left lung. Despite broad spectrum antibiotics combined with an antifungal agent (liposomal amphotericin B) there wasn’t improvement. Chest computed tomography showed a cavitated nodule contacting the left apicl pleural suggesting fungal infection, probably aspergillosis. Voriconazole was started but the radiological image persisted and a month later was performed a left upper lobectomy. Histopathological examination of surgical specimen revealed a mucormycosis. After surgery this boy was treated with liposomal amphotericin B replaced 6 weeks later by oral posaconazol,with good clinical and radiological response. Discussion: This case illustrates the difi culties of differential diagnosis between pulmonary aspergillosis and mucormycosis. The fi rst choice antifungal therapy is amphotericin B. Posaconazole has been used in some cases that didn’t respond to amphotericin B. In most patients surgical debridement of necrotic tissues that not allow antifungal agent penetration is essential. In patients receiving immunossupressor agents secondary prophylaxis shoul be discussed.
Full conference title:
Annual Meeting of the EBMT, 37th
- EBMT 37th (2011)