Invasive splenic mucormycosis due to Rhizopus microsporus during chemotherapy for acute monocytic leukemia: a case report and literature review
Mucormycosis is a rare opportunistic fungal infection associated with high mortality that typically occurs in immunocompromised patients. It is difficult to diagnose owing to non-specific clinical manifestations, the serologic index, imaging features, and the limitations of diagnostic methods. The i...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1237807/full |
| _version_ | 1797689902237745152 |
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| author | Xiru Peng Zixiu Wei Lijuan Wang Juan Cheng Juan Cheng |
| author_facet | Xiru Peng Zixiu Wei Lijuan Wang Juan Cheng Juan Cheng |
| author_sort | Xiru Peng |
| collection | DOAJ |
| description | Mucormycosis is a rare opportunistic fungal infection associated with high mortality that typically occurs in immunocompromised patients. It is difficult to diagnose owing to non-specific clinical manifestations, the serologic index, imaging features, and the limitations of diagnostic methods. The incidence of invasive splenic mucormycosis is extremely rare, with only a few cases documented in the literature. We report a survival case of invasive splenic mucormycosis involving the liver caused by Rhizopus microsporus in a patient during consolidation therapy for acute monocytic leukemia (AML-M5). The patient initially presented with recurrent fever and splenomegaly accompanied by multiple focal hypodensities unresponsive to empiric anti-infective treatment. Splenic mucormycosis was diagnosed by Contrast-Enhanced Ultrasonography (CEUS) and metagenomic next-generation sequencing (mNGS). However, surgical intervention carries a high risk due to the progressive involvement of the liver in invasive splenic mucormycosis. Fortunately, monotherapy with amphotericin B was effective, and the patient underwent allo-HSCT. This case aims to emphasize the importance of utilizing mNGS and CEUS for the timely diagnosis of mucormycosis to help clinicians identify splenic mucormycosis and initiate appropriate therapy as soon as possible to improve therapeutic efficacy and prognosis. |
| first_indexed | 2024-03-12T01:51:57Z |
| format | Article |
| id | doaj.art-11b33bde075240479fa45f3a9c0921bd |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-12T01:51:57Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-11b33bde075240479fa45f3a9c0921bd2023-09-08T10:20:34ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-09-011310.3389/fonc.2023.12378071237807Invasive splenic mucormycosis due to Rhizopus microsporus during chemotherapy for acute monocytic leukemia: a case report and literature reviewXiru Peng0Zixiu Wei1Lijuan Wang2Juan Cheng3Juan Cheng4The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, ChinaThe First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, ChinaDepartment of Hematology, The First Hospital of Lanzhou University, Lanzhou, ChinaThe First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, ChinaDepartment of Hematology, The First Hospital of Lanzhou University, Lanzhou, ChinaMucormycosis is a rare opportunistic fungal infection associated with high mortality that typically occurs in immunocompromised patients. It is difficult to diagnose owing to non-specific clinical manifestations, the serologic index, imaging features, and the limitations of diagnostic methods. The incidence of invasive splenic mucormycosis is extremely rare, with only a few cases documented in the literature. We report a survival case of invasive splenic mucormycosis involving the liver caused by Rhizopus microsporus in a patient during consolidation therapy for acute monocytic leukemia (AML-M5). The patient initially presented with recurrent fever and splenomegaly accompanied by multiple focal hypodensities unresponsive to empiric anti-infective treatment. Splenic mucormycosis was diagnosed by Contrast-Enhanced Ultrasonography (CEUS) and metagenomic next-generation sequencing (mNGS). However, surgical intervention carries a high risk due to the progressive involvement of the liver in invasive splenic mucormycosis. Fortunately, monotherapy with amphotericin B was effective, and the patient underwent allo-HSCT. This case aims to emphasize the importance of utilizing mNGS and CEUS for the timely diagnosis of mucormycosis to help clinicians identify splenic mucormycosis and initiate appropriate therapy as soon as possible to improve therapeutic efficacy and prognosis.https://www.frontiersin.org/articles/10.3389/fonc.2023.1237807/fullinvasive splenic mucormycosisRhizopus microsporusmetagenomic next-generation sequencingcontrast-enhanced ultrasonographyamphotericin B |
| spellingShingle | Xiru Peng Zixiu Wei Lijuan Wang Juan Cheng Juan Cheng Invasive splenic mucormycosis due to Rhizopus microsporus during chemotherapy for acute monocytic leukemia: a case report and literature review Frontiers in Oncology invasive splenic mucormycosis Rhizopus microsporus metagenomic next-generation sequencing contrast-enhanced ultrasonography amphotericin B |
| title | Invasive splenic mucormycosis due to Rhizopus microsporus during chemotherapy for acute monocytic leukemia: a case report and literature review |
| title_full | Invasive splenic mucormycosis due to Rhizopus microsporus during chemotherapy for acute monocytic leukemia: a case report and literature review |
| title_fullStr | Invasive splenic mucormycosis due to Rhizopus microsporus during chemotherapy for acute monocytic leukemia: a case report and literature review |
| title_full_unstemmed | Invasive splenic mucormycosis due to Rhizopus microsporus during chemotherapy for acute monocytic leukemia: a case report and literature review |
| title_short | Invasive splenic mucormycosis due to Rhizopus microsporus during chemotherapy for acute monocytic leukemia: a case report and literature review |
| title_sort | invasive splenic mucormycosis due to rhizopus microsporus during chemotherapy for acute monocytic leukemia a case report and literature review |
| topic | invasive splenic mucormycosis Rhizopus microsporus metagenomic next-generation sequencing contrast-enhanced ultrasonography amphotericin B |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1237807/full |
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