Abstract
BackgroundConidiobolus spp. (mainly C. coronatus) are the causal agents of rhino-facial conidiobolomycosis, a limited soft tissue infection, which is essentially observed in immunocompetent individuals from tropical areas. Rare cases of invasive conidiobolomycosis due to C. coronatus or other species (C.incongruus, C.lamprauges) have been reported in immunocompromised patients. We report here the first case of invasive pulmonary fungal infection due to Conidiobolus pachyzygosporus in a Swiss patient with onco-haematologic malignancy.Case presentationA 71 year-old female was admitted in a Swiss hospital for induction chemotherapy of acute myeloid leukemia. A chest CT performed during the neutropenic phase identified three well-circumscribed lung lesions consistent with invasive fungal infection, along with a positive 1,3-beta-d-glucan assay in serum. A transbronchial biopsy of the lung lesions revealed large occasionally septate hyphae. A Conidiobolus spp. was detected by direct 18S rDNA in the tissue biopsy and subsequently identified at species level as C. pachyzygosporus by 28S rDNA sequencing. The infection was cured after isavuconazole therapy, recovery of the immune system and surgical resection of lung lesions.ConclusionsThis is the first description of C. pachyzygosporus as human pathogen and second case report of invasive conidiobolomycosis from a European country.
Highlights
Conidiobolus spp. are the causal agents of rhino-facial conidiobolomycosis, a limited soft tissue infection, which is essentially observed in immunocompetent individuals from tropical areas
This is the first description of C. pachyzygosporus as human pathogen and second case report of invasive conidiobolomycosis from a European country
We report here a case of C. pachyzygosporus invasive infection limited to the lungs in a patient with acute myeloid leukemia, which was acquired in Switzerland
Summary
Conidiobolus spp. (mainly C. coronatus) are the causal agents of rhino-facial conidiobolomycosis, a limited soft tissue infection, which is essentially observed in immunocompetent individuals from tropical areas. Few cases of disseminated infections involving multiple organs (lungs, heart, kidneys, spleen or brain) have been reported in immunocompromised individuals, such as hematologic cancer patients or solid-organ transplant recipients [5,6,7,8,9,10,11,12,13,14]. We report here a case of C. pachyzygosporus invasive infection limited to the lungs in a patient with acute myeloid leukemia, which was acquired in Switzerland. Case presentation A 71 year-old female of Swiss origin was admitted at the University Hospital of Lausanne (Switzerland) for a diagnosis of acute myeloid leukemia.
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