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Zygomycosis in relapsed acute leukaemia
T Parkyn1, A W McNinch, T Riordan
1Department of Paediatrics, Royal Devon and Exeter Hospital, Exeter, UK.
The Journal of Infection
|December 20, 2000
Summary
Liposomal amphotericin effectively treated mucormycosis in two relapsed acute leukemia patients. High doses of liposomal amphotericin (Ambisome Nexstar) eradicated invasive fungal infections in immunocompromised individuals.
Area of Science:
- Mycology
- Hematology
- Infectious Diseases
Background:
- Mucormycosis is a severe fungal infection often seen in immunocompromised patients, particularly those with hematological malignancies.
- Relapsed acute leukemia patients undergoing intensive chemotherapy are at high risk for opportunistic infections like mucormycosis.
Observation:
- Two patients with relapsed acute leukemia developed invasive mucormycosis during periods of profound pancytopenia.
- One patient presented with a necrotic neck lesion and maxillary sinus opacity, while the other developed periorbital swelling and proptosis, indicative of rhinocerebral mucormycosis.
Findings:
- Both patients were treated with escalating doses of liposomal amphotericin (Ambisome Nexstar), reaching 10 and 15 mg/kg/day.
- Successful eradication of mucormycosis was achieved in both cases following liposomal amphotericin therapy.
Implications:
- Liposomal amphotericin is a viable and effective treatment option for mucormycosis in critically ill, immunocompromised patients.
- Aggressive antifungal therapy with liposomal amphotericin can lead to successful outcomes even in complex cases of invasive fungal infections in relapsed leukemia.
- This case series highlights the importance of early diagnosis and prompt treatment of mucormycosis in patients with hematological malignancies.