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Cunninghamella bertholletiae infection (mucormycosis) in a patient with acute T-cell lymphoblastic leukemia.

Cunninghamella spp. are unusual opportunistic pathogens that have been identified with increased frequency in immunocompromised patients. Clinical infection by this fungus is almost always devastating and usually fatal. Infections with this group of organisms have been seen most frequently in patients with hematological malignancy. Here we report the case of a patient with acute leukemia who developed multiorganic failure as a consequence of hematological dissemination by Cunninghamella bertholletiae. The case highlights the mortality associated with this fungal infection in immunocompromised patients, confirms the risk factors associated with non-candida fungal infections and shows a clinical presentation mimicking myocardial infarct and cerebrovascular stroke.

Adult↗

Mucormycosis (zygomycosis) in a heart-kidney transplant recipient: recovery after posaconazole therapy.

We describe the case of a diabetic patient who developed a severe invasive fungal infection due to Rhizopus species postoperatively after a dual heart/kidney transplantation with subsequent intensive immunosuppressive therapy. No improvement was noted with amphotericin B (deoxycholate) therapy, but salvage treatment with the new azole antifungal posaconazole (200 mg orally 4 times daily) resulted in dramatic clinical improvement as early as 1 week after the initiation of therapy that continued through 23 weeks of treatment, with marked clinical, mycological, and radiological improvements and no adverse events.

Antifungal Agents↗

Pulmonary mucormycosis caused by Cunninghamella elegans in a patient with chronic myelogenous leukemia.

Cunninghamella elegans was cultured from autopsy materials of the infected lung of a patient with chronic myelogenous leukemia. The histologic sections revealed extensive growth of nonseptate, broad hyphae in and about the large and small arteries and veins, occluding the vessels. This case is believed to be the second in which human infection by C. elegans has been documented.

Fungi↗