Cunninghamella bertholletiae Infection in a HLA-Haploidentical Hematopoietic Stem Cell Transplant Recipient with Graft Failure: Case Report and Review of the Literature

Mycopathologia. 2016 Oct;181(9-10):753-8. doi: 10.1007/s11046-016-0030-7. Epub 2016 Jun 28.

Abstract

Cunninghamella bertholletiae as a rare cause of mucormycosis has been described almost exclusively in immunosuppressed patients such as hematopoietic stem cell transplant (HSCT) recipients. The infection is associated with high rates of mortality despite aggressive treatment. We describe a 40-year-old male with HLA-haploidentical HSCT developed fungal pneumonitis caused by C. bertholletiae complicated by graft failure and prolonged neutropenia. The patient died 102 days after HSCT despite early use of posaconazole and amphotericin B, which are believed to be the two most effective antifungal antibiotics against C. bertholletiae. The case highlights extreme unfavorable outcome in C. bertholletiae infection and neutropenia as a major risk factor.

Keywords: Cunninghamella; Fungal pneumonia; Mucormycosis; Stem cell transplantation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Cunninghamella / classification*
  • Cunninghamella / isolation & purification*
  • Fatal Outcome
  • Graft Rejection / complications*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Microbiological Techniques
  • Microscopy
  • Mucormycosis / diagnosis*
  • Mucormycosis / microbiology
  • Mucormycosis / pathology*
  • Thorax / diagnostic imaging
  • Tomography, X-Ray Computed
  • Transplant Recipients
  • Triazoles / therapeutic use

Substances

  • Antifungal Agents
  • Triazoles
  • posaconazole
  • Amphotericin B