Hepatic and small bowel mucormycosis after chemotherapy in a patient with acute lymphocytic leukemia.
10.3346/jkms.2000.15.3.351
- Author:
Ill Woo SUH
1
;
Chul Sung PARK
;
Mi Suk LEE
;
Je Hwan LEE
;
Mee Soo CHANG
;
Jun Hee WOO
;
In Chul LEE
;
Ji So RYU
Author Information
1. Department of Infectious Diseases, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Mucormycosis;
Liver;
Intestine Small;
Leukemia, Lymphocytic, Acute
- MeSH:
Case Report;
Female;
Human;
Intestinal Diseases/therapy;
Intestinal Diseases/radiography;
Intestinal Diseases/pathology*;
Intestinal Diseases/microbiology;
Intestine, Small/radiography;
Intestine, Small/pathology;
Liver Diseases/therapy;
Liver Diseases/radiography;
Liver Diseases/pathology*;
Liver Diseases/microbiology;
Middle Age;
Mucormycosis/therapy;
Mucormycosis/radiography;
Mucormycosis/pathology*;
Mucormycosis/microbiology;
Tomography Scanners, X-Ray Computed
- From:Journal of Korean Medical Science
2000;15(3):351-354
- CountryRepublic of Korea
- Language:English
-
Abstract:
Mucormycosis is a rare but invasive opportunistic fungal infection with increased frequency during chemotherapy-induced neutropenia. The clinical infections due to Mucor include rhinocerebral, pulmonary, cutaneous, gastrointestinal and disseminated diseases. The first two are the most common diseases and all entities are associated with a high mortality rate. Still hepatic involvement of Mucor is rarely reported. We experienced a case of hepatic and small bowel mucormycosis in a 56-year-old woman after induction chemotherapy for B-cell acute lymphocytic leukemia. Initial symptoms were a high fever unresponsive to broad spectrum antibiotics and pain in the left lower abdominal quadrant. It was followed by septic shock, deterioration of icterus and progressively elevated transaminase. An abdominal CT demonstrated multiple hypodense lesions with distinct margins in both lobes of liver and pericolic infiltration at small bowel and ascending colon. Diagnosis was confirmed by biopsy of the liver. The histopathology of the liver showed hyphae with the right-angle branching, typical of mucormycosis. The patient was managed with amphotericin B and operative correction of the perforated part of the small bowel was performed. However, the patient expired due to progressive hepatic failure despite corrective surgery and long-term amphotericin B therapy.
