Sino-oral zygomycosis due toAbsidiacorymbiferain a patient with acute leukemia

Abstract

Fungi belonging to class Zygomycetes become pathogenic in certain predisposing conditions; principally diabetes mellitus, immunosuppression, trauma or burns. We report a case of a 31-year-old man with acute promyelocytic leukemia who developed infection of the sino-oral cavity, due to Absidia corymbifera during a neutropenic phase following induction chemotherapy. A provisional diagnosis of zygomycosis was made by demonstration of broad aseptate branching filamentous hyphae in the scrapings of the palate, which was subsequently confirmed as A. corymbifera by culture. Surgical debridement could not be done due to the thrombocytopenic status of the patient; instead antifungal therapy with amphotericin B was instituted. However, the patient succumbed to the infection after 15 days of its diagnosis. Although infections with Absidia are infrequent, this case highlights the need for its awareness as a potentially lethal opportunistic fungal infection that can present even with short duration of exposure to the usual risk factors.

Clinical presentation of zygomycosis

“…More importantly, a substantial number of cases were reported in individuals with no clear predisposing factors. Recently, a substantial increase in the numbers of cases of zygomycosis has been noted in profoundly neutropenic patients with high‐risk leukaemia [16–27], in patients with myelodysplastic syndromes [28–30], and in haematopoietic stem cell [31–34] and solid organ transplant recipients [35–39]. Earthquakes and physical disasters, such as the 2004 tsunami in Southeast Asia, have also been linked with increases in the numbers of cases of cutaneous and subcutaneous zygomycosis due to traumatic inoculation of zygomycetes into wounds [40–42].…”

Septic Arthritis due to Absidia corymbifera in a Patient with HIV-1 Infection

“…Trauma, penetrating injuries and burns have been described as predisposing factors to zygomycosis in the setting of diabetes and immunosuppression [6][7][8] leading to pulmonary, cutaneous or disseminated infection among others [9][10][11]. None of these predisposing factors were present in our patient.…”