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Skin and Soft Tissue Mucormycosis in Patients Receiving Bruton Tyrosine Kinase Inhibitors: Case Report and Literature
Eduardo Aparicio-Minguijón1, Nieves López-Muñoz2, Jorge Boán1
1Unit of Infectious Diseases, Hospital Universitario "12 de Octubre," Instituto de Investigación Sanitaria Hospital "12 de Octubre," Madrid, Spain.
Abstract:
Bruton tyrosine kinase inhibitors (BTKis) have been associated with an increased risk of invasive fungal disease, with skin and soft tissue mucormycosis accounting for a minority of cases. We present a 72-year-old patient with chronic lymphocytic leukemia who developed necrotizing fasciitis and myositis due to Lichtheimia spp after 4 months of therapy with the second-generation BTKi zanubrutinib, with a fatal outcome despite aggressive treatment. Our literature review identified 7 additional cases of BTKi-associated skin and soft tissue mucormycosis, revealing an all-cause mortality rate of 37.5%. Two-thirds of the patients had a previous trauma or skin lesion.
Insights
Bruton tyrosine kinase inhibitors (BTKis) increase invasive fungal disease risk. A fatal case of Lichtheimia-associated necrotizing fasciitis highlights this rare but severe complication, with a 37.5% mortality rate in BTKi users.
Area of Science:
- Oncology
- Infectious Diseases
- Dermatology
Background:
- Bruton tyrosine kinase inhibitors (BTKis) are increasingly used for B-cell malignancies.
- BTKis are associated with an increased risk of invasive fungal infections.
- Skin and soft tissue mucormycosis is a rare but severe manifestation of BTKi-associated fungal disease.
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