Pulmonary Mucormycosis in an Older Acute Myeloid Leukemia Patient.

Journal of medical cases Pub Date : 2025-01-01 Epub Date: 2024-11-23 DOI:10.14740/jmc5042
Bing Qing Luo, Xiao Yan Tan, Ying Chen, Lin Chen
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Abstract

Mucormycosis is a rare but fatal opportunistic fungal infection. Patients with hematologic malignancies who use immunosuppressant and glucocorticoid extensively are susceptible to mucormycosis. We report a case of an older patient with acute myeloid leukemia (AML) who was infected with pulmonary mucormycosis during chemotherapy. With a good balance of chemotherapy-induced myelosuppression and control of Mucorales infection, the patient got a complete remission of leukemia by the combination of azacitidine and venetoclax, and pulmonary mucormycosis was well controlled. But due to poor compliance, the patient died of asphyxiation as a result of aspiration of pulmonary necrosis-like substances after discharge. To our knowledge, this is the first case report of an older patient with AML complicated with pulmonary mucormycosis dying of asphyxia from pulmonary necrosis-like substances. Our article seeks to raise awareness of proper precautions to be taken in the management mucormycosis.

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老年急性髓性白血病患者的肺毛霉菌病。
毛霉病是一种罕见但致命的机会性真菌感染。恶性血液病患者广泛使用免疫抑制剂和糖皮质激素易患毛霉病。我们报告一例老年急性髓性白血病(AML)患者在化疗期间感染肺毛霉菌病。在化疗诱导的骨髓抑制与Mucorales感染控制的良好平衡下,患者经阿扎胞苷联合venetoclax治疗后白血病完全缓解,肺mucormycosis得到很好的控制。但由于依从性差,患者出院后因吸入肺坏死样物质窒息死亡。据我们所知,这是首例老年AML合并肺毛霉菌病患者因肺坏死样物质窒息死亡的病例报告。我们的文章旨在提高在管理毛霉病时应采取的适当预防措施的认识。
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