Combined antifungal therapy, iron chelation and surgical resection as treatment of hepatic zygomycosis in a patient with haematological malignancy: Letter to the editor

Alessandro Busca, Filippo Marmont, Franco Locatelli, Giorgio Limerutti, Maria Teresa Sorrentino, Anna Barbui, Damiano Patrono, Mauro Salizzoni, Ezio David, Francesco De Rosa

Research output: Contribution to journalArticlepeer-review

Abstract

We describe the case of a 19-year-old boy with acute leukaemia who developed primary hepatic zygomycosis. The patient presented with febrile neutropenia and severe abdominal tenderness. Despite the administration of antibiotics and liposomal Amphotericin-B (L-AmB), the CT scan demonstrated an increase in the size of liver lesions. A wide surgical resection was carried out and liver specimens demonstrated a branching, filamentous fungus that was identified as Rhizomucor pusillus by both phenotypic and molecular methods. The patient was treated with L-AmB combined with posaconazole, and deferasirox was subsequently added given the potential synergistic effect of this iron chelator in combination with L-AmB. Three months after surgical intervention, an allogeneic stem-cell transplantation was successfully carried out. The present case confirms that an early surgical management combined with antifungal agents is crucial to optimise the outcome of patients with zygomycosis and the use of deferasirox is a promising alternative.

Original languageEnglish
Pages (from-to)275-278
Number of pages4
JournalMycoses
Volume53
Issue number3
DOIs
Publication statusPublished - May 2010

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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