Septic mucormycosis in acute t-cell leucemia – pathogen detection in skin lesions

Häfliger, Stefanie; Blanc Bühlmann, Andrea Marina; Beltraminelli, Helmut; Blum, Roland (2013). Septic mucormycosis in acute t-cell leucemia – pathogen detection in skin lesions (Unpublished). In: 95. Jahresversammlung der SGDV. Montreux. 19.-21.09.2013.

[img] Slideshow
dermatologica helvetica_9_p.pptx - Presentation
Available under License BORIS Standard License.

Download (14MB)

We report on a 43-year old patient with an acute T-Cell Leucemia, currently in Aplasia after Chemotherapy, showing five targetoid bluish skin lesions. Due to a three weeks history of septic symptoms he was under treatment with antibiotics and antifungals. Multiple septic foci were localized (N. caudatus, liver, kidneys, lung, spine and right psoas). Microbiology analyses of various blood cultures and of the aspirate of the psoas abscess showed initially negative results. Clinically the skin lesions were suspected to be of septic or thrombogenic origin. A 5 mm punch biopsy was performed and separated for microbiological diagnostic and conventional histology. Surprisingly large fungal agents in mostly intravascular distribution were seen histologically and identified as Lichtheimia corymbifera (syn. Absidia corymbifera) by PCR. Cultures remained negative. The patient died on the following day. Lichtheimia corymbifera is a fungus belonging to the family of mucormycosis. Aspergillosis and mucormycosis are the most common mold infections in patients with hematological malignancies, clinically often indistinguishable. However, the true incidence of mucormycosis is not known and probably underestimated because of difficulties in diagnosis. Mucormycosis typically causes acute, aggressive, and frequently angioinvasive infections presenting with solitary local skin necrosis. The fact that the pathogenic fungus was isolated from a very discrete skin lesion but was not detected in blood cultures, and only later in the PCR of the aspirate of the psoas abscess, makes this case exceptional.

Item Type:

Conference or Workshop Item (Poster)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Häfliger, Stefanie; Blanc Bühlmann, Andrea Marina; Beltraminelli, Helmut and Blum, Roland

Subjects:

600 Technology > 610 Medicine & health

Language:

English

Submitter:

Monika Schenk

Date Deposited:

11 Jun 2014 17:05

Last Modified:

11 Jun 2014 17:05

BORIS DOI:

10.7892/boris.47354

URI:

https://boris.unibe.ch/id/eprint/47354

Actions (login required)

Edit item Edit item
Provide Feedback