Onkológia 2/2014

Systemic invasive mucormycosis as a cause of early death of a child with acute myelogenous leukemia

Purpose: The objective is to present a case report of a patient with acute myeloid leukemia and to demonstrate how can a rare form of invasive fungal infection, invasive mucormycosis, significantly complicate the treatment of patient with hematologic malignancy. Case: We describe a 3-year-old patient with acute monocytic leukemia with MLL translocation t(9,11). After the induction chemotherapy was completed, a febrile neutropenia developed and did not respond to standard supportive treatment. Despite an intensive antiinfectious and supportive treatment the patient´s condition rapidly progressed to multiorgan failure and resulted into death within 26 days since diagnosis. Comprehensive diagnostic microbiological and serological tests failed to identify the etiological agent. The cause of such an aggressive course was identified only post mortem as disseminated mucormycosis, Lichtheimia corymbifera. Conclusion: Mucormycosis is an emerging cause of infectious morbidity and mortality among patients with hematological malignancies. These infections require multidisciplinary integrated care, often highly individualized and progressive complex decisions during diagnostic and therapeutic process. Despite huge efforts of the caring team, disseminated form of mucormycosis in patients with leukemia, the result is not always successful. Mortality of disseminated form of mucorsis is about 90%.

Keywords: acute myeloid leukemia, mucormycosis, Lichtheimia corymbifera.