[Invasive sinusitis after allogenic stem cell transplantation - Case 4/2010]

Area of Science:

• Mycology
• Infectious Diseases
• Hematology

Background:

• This case highlights a rare but severe fungal infection, mucormycosis, occurring in an immunocompromised patient post-stem cell transplantation.
• The patient had chronic graft-versus-host disease requiring ongoing immunosuppressive therapy, a known risk factor for opportunistic infections.

Observation:

• A patient presented with dyspnea and ptosis, leading to the discovery of an orbital tumor.
• CT scans revealed an orbita-infiltrating tumor, diagnosed as mucormycosis via biopsy, with subsequent identification of cerebral involvement.

Findings:

• The rhino-orbito-cerebral mucormycosis was treated with dose-intensive liposomal amphotericin B and posaconazole maintenance therapy.
• This systemic antifungal approach led to stabilization and continuous regression of the infection.

Implications:

• Mucormycosis, despite its low incidence, warrants inclusion in diagnostic considerations due to its rapid progression and high mortality.
• Effective management involves biopsy confirmation, addressing underlying risk factors (immunosuppression, cytopenia), and targeted antimycotic therapy, potentially combined with operative intervention.