Conidiobolus pachyzygosporus invasive pulmonary infection in a patient with acute myeloid leukemia: case report and review of the literature.
Aged
Antifungal Agents
/ therapeutic use
Biopsy
Conidiobolus
/ genetics
DNA, Fungal
/ genetics
DNA, Ribosomal
/ genetics
Female
Humans
Hyphae
/ isolation & purification
Immunocompromised Host
Leukemia, Myeloid, Acute
/ complications
Lung Diseases, Fungal
/ complications
Nitriles
/ therapeutic use
Pyridines
/ therapeutic use
Switzerland
Tomography, X-Ray Computed
Treatment Outcome
Triazoles
/ therapeutic use
Zygomycosis
/ complications
Conidiobolomycolosis
Enthomophthoramycosis
Entomophthorales
Invasive fungal infections
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
22 Jul 2020
22 Jul 2020
Historique:
received:
30
12
2019
accepted:
02
07
2020
entrez:
24
7
2020
pubmed:
24
7
2020
medline:
29
8
2020
Statut:
epublish
Résumé
Conidiobolus spp. (mainly C. coronatus) are the causal agents of rhino-facial conidiobolomycosis, a limited soft tissue infection, which is essentially observed in immunocompetent individuals from tropical areas. Rare cases of invasive conidiobolomycosis due to C. coronatus or other species (C.incongruus, C.lamprauges) have been reported in immunocompromised patients. We report here the first case of invasive pulmonary fungal infection due to Conidiobolus pachyzygosporus in a Swiss patient with onco-haematologic malignancy. A 71 year-old female was admitted in a Swiss hospital for induction chemotherapy of acute myeloid leukemia. A chest CT performed during the neutropenic phase identified three well-circumscribed lung lesions consistent with invasive fungal infection, along with a positive 1,3-beta-d-glucan assay in serum. A transbronchial biopsy of the lung lesions revealed large occasionally septate hyphae. A Conidiobolus spp. was detected by direct 18S rDNA in the tissue biopsy and subsequently identified at species level as C. pachyzygosporus by 28S rDNA sequencing. The infection was cured after isavuconazole therapy, recovery of the immune system and surgical resection of lung lesions. This is the first description of C. pachyzygosporus as human pathogen and second case report of invasive conidiobolomycosis from a European country.
Sections du résumé
BACKGROUND
BACKGROUND
Conidiobolus spp. (mainly C. coronatus) are the causal agents of rhino-facial conidiobolomycosis, a limited soft tissue infection, which is essentially observed in immunocompetent individuals from tropical areas. Rare cases of invasive conidiobolomycosis due to C. coronatus or other species (C.incongruus, C.lamprauges) have been reported in immunocompromised patients. We report here the first case of invasive pulmonary fungal infection due to Conidiobolus pachyzygosporus in a Swiss patient with onco-haematologic malignancy.
CASE PRESENTATION
METHODS
A 71 year-old female was admitted in a Swiss hospital for induction chemotherapy of acute myeloid leukemia. A chest CT performed during the neutropenic phase identified three well-circumscribed lung lesions consistent with invasive fungal infection, along with a positive 1,3-beta-d-glucan assay in serum. A transbronchial biopsy of the lung lesions revealed large occasionally septate hyphae. A Conidiobolus spp. was detected by direct 18S rDNA in the tissue biopsy and subsequently identified at species level as C. pachyzygosporus by 28S rDNA sequencing. The infection was cured after isavuconazole therapy, recovery of the immune system and surgical resection of lung lesions.
CONCLUSIONS
CONCLUSIONS
This is the first description of C. pachyzygosporus as human pathogen and second case report of invasive conidiobolomycosis from a European country.
Identifiants
pubmed: 32698804
doi: 10.1186/s12879-020-05218-w
pii: 10.1186/s12879-020-05218-w
pmc: PMC7374966
doi:
Substances chimiques
Antifungal Agents
0
DNA, Fungal
0
DNA, Ribosomal
0
Nitriles
0
Pyridines
0
Triazoles
0
isavuconazole
60UTO373KE
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
527Références
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