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Phycomycosis infection in acute leukaemia.
1Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi.
The Journal of the Association of Physicians of India
|October 1, 1990
Summary
Mucormycosis is a serious fungal infection affecting patients with acute leukemia undergoing chemotherapy. Early diagnosis and treatment with amphotericin-B are crucial for improving outcomes in these vulnerable patients.
Area of Science:
- Mycology
- Hematology
- Infectious Diseases
Background:
- Fungal infections, particularly mucormycosis, pose a significant threat to immunocompromised patients undergoing intensive chemotherapy for acute leukemia.
- Conventional treatments often involve broad-spectrum antibiotics, but invasive fungal infections require specific antifungal agents.
Observation:
- Three cases of mucormycosis were observed in patients with acute leukemia (two acute lymphoblastic leukemia, one acute myeloid leukemia) during the neutropenic phase post-chemotherapy.
- Clinical presentations included fever and pulmonary infiltrates unresponsive to antibiotics; body fluid cultures were frequently negative.
- Diagnosis was confirmed via biopsy in one patient, leading to successful treatment, while two cases were diagnosed post-mortem.
Findings:
- Mucormycosis diagnosis in acute leukemia patients can be challenging due to non-specific symptoms and negative cultures.
- Early detection through high clinical suspicion in febrile, neutropenic patients is critical.
- Timely administration of amphotericin-B is associated with improved survival rates.
Implications:
- Increased vigilance for mucormycosis in acute leukemia patients receiving chemotherapy is warranted.
- Prompt initiation of appropriate antifungal therapy, such as amphotericin-B, can significantly impact patient prognosis.
- Disseminated mucormycosis carries a poor prognosis, emphasizing the need for early intervention.