Hepatic and Small Bowel Mucormycosis after Chemotherapy in a Patient with Acute Myeloid Leukemia: A Case Report and Literature Review.
- Author:
Tae Un YANG
1
;
Sun Hwa KIM
;
Byeong Kwang CHOI
;
Soon Wook LEE
;
Joo Hee PARK
;
Kyung Wook HONG
;
In Sun KIM
;
Yu Bin SEO
;
Chul Won CHOI
;
Woo Joo KIM
Author Information
- Publication Type:Case Report
- Keywords: Small bowel; Mucormycosis; Acute myeloid leukemia; Chemotherapy
- MeSH: Abscess; Amphotericin B; Anti-Bacterial Agents; Biopsy; C-Reactive Protein; Ciprofloxacin; Deoxycholic Acid; Drainage; Female; Fever; Fungi; Humans; Ileus; Induction Chemotherapy; Klebsiella pneumoniae; Leukemia, Myeloid, Acute; Liver Abscess; Mucor; Mucormycosis; Risk Factors; Thienamycins; Triazoles
- From:Infection and Chemotherapy 2012;44(6):516-521
- CountryRepublic of Korea
- Language:Korean
- Abstract: We present a case of a 64-year-old woman with acute myeloid leukemia who developed a hepatic abscess during the neutropenic period after induction chemotherapy. To treat the abscess, meropenem and ciprofloxacin were administered to target Klebsiella pneumoniae and percutaneous drainage performed. As a result, the patient's fever and c-reactive protein (CRP) subsequently improved. After six weeks of antibiotic therapy, an abdominal computed tomography scan revealed remains of the liver abscess as well as an ileus in the small bowel. Molds from the Mucor genus were cultured from repeated liver abscess drainage and an abscess wall biopsy confirmed hepatic mucormycosis. Along with administration of amphotericin-B deoxycholate for four weeks, we performed lobectomy for hepatic mucormycosis and small bowel resection for a suspected small bowel mucormycosis. After these operations, the patient received liposomal amphotericin B for three weeks and was then maintained with oral posaconazole for more than four weeks. Our case report suggests that hepatic mucormycosis should be considered when a hepatic abscess exhibits a retarded response to antibacterial agents, especially for patients with risk factors. In addition, because an isolated hepatic mucormycosis is infrequent, a thorough search for the extent of the disease is necessary before surgical resection.
