1. Sudden death in a patient with bone marrow transplant by a fungus among us.
- Author
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Non L, Sta Cruz JP, and Tuazon S
- Subjects
- Aged, Biopsy, Needle, Bone Marrow Transplantation methods, Disease Progression, Female, Humans, Immunohistochemistry, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute drug therapy, Lung Diseases, Fungal drug therapy, Mucormycosis drug therapy, Postoperative Complications diagnosis, Postoperative Complications drug therapy, Postoperative Complications microbiology, Tomography, X-Ray Computed methods, Bone Marrow Transplantation adverse effects, Death, Sudden, Leukemia, Myeloid, Acute surgery, Lung Diseases, Fungal diagnosis, Mucormycosis diagnosis
- Abstract
Mucormycosis is rare, presenting as breakthrough infection among haematological and transplant patients on prophylaxis with voriconazole. We report an unusual presentation of this infection, that which is pneumonia progressing to cardiac arrest. A 68-year-old woman with refractory acute myelogenous leukaemia on voriconazole prophylaxis was initially admitted for neutropenic fever and pneumonia. She was discharged improved on antibiotics and voriconazole for presumed aspergillosis. She returned after 1 month with the same presentation. She eventually improved on antibiotics and voriconazole, and eventually received bone marrow transplantation. Three days later, she developed pleuritic chest pain, dyspnoea, and hypoxia requiring intubation. An hour after intubation, the patient arrested and expired. Autopsy revealed Rhizopus pneumonitis with pulmonary infarction, and emboli to her cerebellum, heart, thyroid and kidney. Mucormycosis is an emerging, fatal infection that should be suspected in haematological and transplant patients who deteriorate on voriconazole., (2014 BMJ Publishing Group Ltd.)
- Published
- 2014
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