Systemic pseudallescheriasis in a patient with acute myelocytic leukemia

Presented is a case of widely disseminated systemic pseudallescheriasis in a 41 year old male with acute myelocytic leukemia. The immediate cause of death appeared to be due to an extensive invasion of the lungs which showed massive intra-alveolar hemorrhages, congestion, mycotic thrombi, and multiple fungal lesions in all lobes. Pseudallescheria boydii was diagnosed histopathologically by virtue of its characteristic conidia present in miliary lesions throughout a wide range of host's tissues, including the brain and the thyroid. Three antemortem blood specimens cultured during the patient's final hospital stay were positive for the fungus. It was concluded the fungemia was responsible for the rapid and widespread dispersion of P. boydii in this debilitated patient who was granulocytopenic and immunosuppressed.