Mucormycosis in a patient with acute myeloblastic leukemia following liver transplantation for Wilson's disease

Ann Agric Environ Med. 2019 Dec 19;26(4):665-668. doi: 10.26444/aaem/105533. Epub 2019 Mar 18.

Abstract

A case is presented of mucormycosis in a patient with acute myeloblastic leukemia following liver transplantation for Wilson's disease. A 58-year-old female was admitted to the Department of Haematology with deterioration of her general condition, loss of appetite, tiredness and difficulty with mental contact for a few days. Blood and urine cultures for bacteria and fungus, galactomannan antigen were negative. Whole body computed tomography demonstrated bilateral hilar lymphadenopathy with necrotic lesions: splenomegaly with a hypodensive lesion 13 × 20 × 19 mm and lower pulmonary infiltrates suggested fungal etiology. Magnetic resonance imaging of the brain showed thickened meninges. Finally, mucormycosis was diagnosed. Treatment with amphotericin B lipid complex was started, resulting in an partial improvement of the general condition and decreased level of inflammatory markers. However, the patient's condition continued to deteriorate, with sepsis etiology Escherichia coli, and despite the intensive managements she eventually died.

Keywords: Mucormycosis; Willson’s disease; acute myeloblastic leukemia; liver transplantation.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / administration & dosage
  • Antifungal Agents / administration & dosage
  • Fatal Outcome
  • Female
  • Hepatolenticular Degeneration / complications
  • Hepatolenticular Degeneration / surgery*
  • Humans
  • Leukemia, Myeloid, Acute / complications*
  • Liver Transplantation / adverse effects*
  • Middle Aged
  • Mucormycosis / diagnosis
  • Mucormycosis / diagnostic imaging
  • Mucormycosis / drug therapy
  • Mucormycosis / etiology*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology*

Substances

  • Antifungal Agents
  • Amphotericin B