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Nosocomial infection by Rhizomucor pusillus in a clinical haematology unit
Abstract:
Three patients suffering from acute leukaemia were treated with cytotoxic agents and broad-spectrum antibiotics and received blood transfusion and nasal packing for severe epistaxis. All developed necrosis of nasal and facial tissues, with facial swelling an oedema; two biopsies showed typical phycomycete mycelium, and Rhizomucor pusillus was grown from one biopsy. Air and surfaces in the unit and the air intake and ducting were all heavily colonized by Rh. pusillus and other phycomycetes. It is suggested that Rh. pusillus spores from the air invaded the tissues in the conditions promoted by the nasal packing in these patients with impaired defences.
Insights
Rhizomucor pusillus, a phycomycete, caused nasal tissue necrosis in leukemia patients undergoing treatment. Airborne spores likely invaded tissues facilitated by nasal packing and compromised immune defenses.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Acute leukemia patients often have compromised immune systems.
- Severe epistaxis in leukemia patients may require nasal packing.
- Fungal infections, particularly mucormycosis, are a risk for immunocompromised individuals.
Purpose of the Study:
- To investigate a case of phycomycosis in immunocompromised patients.
- To identify the causative agent and potential source of infection.
- To understand the pathogenesis of fungal tissue necrosis in this context.
Main Methods:
- Clinical case observation of three acute leukemia patients.
- Histopathological examination of tissue biopsies.
- Microbiological culture and identification of fungi from biopsies and environmental samples.
Main Results:
- All three patients developed severe nasal and facial tissue necrosis.
- Phycomycete mycelium was identified in two biopsies, with Rhizomucor pusillus cultured from one.
- Rhizomucor pusillus and other phycomycetes heavily colonized the hospital environment, including air and ducting.
Conclusions:
- Rhizomucor pusillus infection led to tissue necrosis in leukemia patients.
- Airborne fungal spores likely invaded tissues, exacerbated by nasal packing and immunosuppression.
- Environmental contamination with Rhizomucor pusillus poses a significant risk to vulnerable patients.