Disseminated Cunninghamella bertholletiae Infection During Induction Chemotherapy in a Girl with High-Risk Acute Lymphoblastic Leukemia

Abstract

Invasive fungal infections in children with acute lymphoblastic leukemia have been a major cause of mortality. Recent reports have described increasing incidence of invasive non-Aspergillus mold infections in patients with hematological malignancies. It is always challenging to treat invasive fungal infection and underlying hematological malignancies successfully. Here we report a girl with high-risk acute lymphoblastic leukemia who developed disseminated Cunninghamella bertholletiae infection during induction chemotherapy. This case illustrates the difficulties of diagnosis and treatment of invasive C. bertholletiae infection. It also highlights the necessity for physicians to keep high suspicion and awareness for this infrequent fungal infection.

Disseminated Cunninghamella elegans Infection Diagnosed by mNGS During Induction Therapy in a Child With Intermediate-risk Acute Lymphoblastic Leukemia: A Case Report and Review of Literature

“…Notably, there were 4 children suffered from Cunninghamella infection after allogeneic hematopoietic stem cell transplantation (Table 2). 5,[11][12][13][14][15][16][17][18][19][20][21][22][23][24] A research conducted by Navanukroh et al 25 has elucidated that respiratory system, especially the lung, was the most affected organ of infection. Consistently, from the case series, we noticed that the pulmonary infection reached 88.2%, also involving skin (23.5%), spleen (11.8%), heart (11.8%), muscle (11.8%), brain, kidney, liver, throat, esophagus, stomach, and ileum.…”

Successful treatment of invasive fungal rhinosinusitis caused by Cunninghamella: A case report and review of the literature

“…However, this kind of IFD usually appears as a disseminated type and has a very poor prognosis. Su et al[11] reported a disseminated Cunninghamella infection in a girl with acute lymphoblastic leukemia, who ultimately died of disseminated intravascular coagulopathy. Strasfeld et al[12] presented three cases of invasive Cunninghamella infection in allogeneic transplant recipients: two of the disseminated type and one pulmonary type.…”