Disseminated Mucormycosis Caused by Absidia corymbifera  
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.