Disseminated Mucormycosis Caused by Absidia
corymbifera |
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http://www.springerlink.com/app/home/contribution.asp?wasp=b54e4b9014f945afacf5e69672ad0d22&referrer=parent&backto=issue,14,18;journal,30,35;linkingpublicationresults,1:103905,1
Infection
Publisher: Urban & Vogel GmbH
ISSN: 0300-8126 (Paper) 1439-0973 (Online)
DOI: 10.1007/s150100070047
Issue: Volume 28, Number 4
Date: August 2000
Pages: 246 - 250
Disseminated Mucormycosis Caused by Absidia corymbifera Leading
to Cerebral Vasculitis
J. Eucker A1, O. Sezer A1, R.. Lehmann A2, J. R. Weber A3, B.
Graf A4, C. Denkert A5, W. Brück A6, M. Schweigert A1, K.
Possinger A1
A1 Medical Clinic, Hermatology and Oncology, Charité University
Hospital, D-10098 Berlin, Germany; Phone: +49-30-28024673, Fax:
+49-30-28023409, e-mail:
sezer@charite.de
A2 Institute for Radiodiagnosis, Dept. of Neuroradiology,
Charité University Hospital, Berlin, Germany
A3 Neurological Clinic, Charité University Hospital, Berlin,
Germany
A4 Institute for Microbiology and Hygiene, Charité University
Hospital, Berlin, Germany
A5 Institute for Pathology, Charité University Hospital, Berlin,
Germany
A6 Institute for Neuropathology, Charité University Hospital,
Berlin, Germany
Abstract:
Summary
An 18-year-old woman was admitted to hospital because of
subcutaneous hematoma and fever of unknown origin. Acute myeloid
leukemia was diagnosed and empirical antimicrobial treatment and
induction chemotherapy were started. After initial defervescence,
fever relapsed 21 days after the onset of neutropenia. The CT
scan of the lung was consistent with an invasive fungal
infection. Treatment with amphotericin B was started and
antimicrobial treatment was continued with liposomal
amphotericin B because of an increase in creatinine later. The
fever persisted and the patient suddenly developed progressive
neurological symptoms. CT scan of the head suggested cerebral
infarction and angiography of the extra- and intracranial
arteries showed signs of vasculitis. Six days after the onset of
neurological symptoms cerebral death was diagnosed. Autopsy
revealed non-septate, irregularly branched hyphae in various
histologic sections including brain. Absidia corymbifera could
be isolated from lung tissue confirming the diagnosis of
disseminated mucormycosis. In this case, angiographic findings
suggested severe cerebral vasculitis which was in fact caused by
thromboembolic dissemination of fungal hyphae. This case
underlines the fact that cerebral symptoms in febrile
neutropenic patients are highly indicative for fungal infections
of the brain. |
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