Fatal mucormycosis and aspergillosis coinfection associated with haemophagocytic lymphohistiocytosis: A case report and literature review - 17/03/23

Doi : 10.1016/j.mycmed.2022.101325

Dorian Loubet ^a, Benjamine Sarton ^b,^c, Lucie Lelièvre ^d, Gaspard Grouteau ^d, Xavier Iriart ^a,^f, Pamela Chauvin ^a, Judith Fillaux ^a, Alexis Valentin ^a,^e, Antoine Berry ^a,^f, Stein Silva ^b,^c, Fabrice Bonneville ^g, Sophie Cassaing ^a,^h, Emilie Guemas ^a,^f,^⁎
^a Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France
^b Critical Care Unit, University Hospital of Purpan, Toulouse, France
^c Toulouse NeuroImaging Center, Unité Mixte de Recherche 1214, Institut National de la Santé et de la Recherche Médicale, Université Paul Sabatier, Toulouse, France
^d Department of Infectious and Tropical Diseases, CHU Toulouse, Toulouse, France
^e PHARMA-Dev, UMR 152 IRD-UPS, Université Toulouse, France
^f Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
^g Neuroradiology Department, Pierre-Paul-Riquet/Purpan University Hospital, Toulouse, France
^h RESTORE Institute, UMR 1301-Inserm 5070-CNRS EFS Univ. P. Sabatier, Toulouse, France

^⁎Corresponding author at: Service de Parasitologie – Mycologie, Hôpital Purpan – Institut Fédératif de Biologie (IFB), 330 avenue de Grande-Bretagne, TSA 40031, 31059 Toulouse cedex 9, FranceService de Parasitologie – Mycologie, Hôpital Purpan – Institut Fédératif de Biologie (IFB)330 avenue de Grande-Bretagne, TSA 40031Toulouse cedex31059France

Abstract

Invasive mould infections are life-threatening and mainly occur in immunocompromised patients. Whereas aspergillosis is described during haemophagocytic lymphohistiocytosis (HLH), only a few cases of concomitant mucormycosis with HLH have been reported. Here, we present an uncommon coinfection of mucormycosis and aspergillosis associated with HLH probably due to a varicella zoster virus (VZV) viraemia which was unresponsive to triple antifungal therapy (liposomal amphotericin B combined with isavuconazole and caspofungin). A review of the cases of mucormycosis with HLH showed that this uncommon association was always lethal and underscored the relevance of screening for mould infections in patients with HLH.

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Keywords : Mucormycosis, Aspergillosis, Invasive fungal infection, Haemophagocytic lymphohistiocytosis, Varicella zoster virus

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Vol 33 - N° 1

Article 101325- mars 2023 Retour au numéro

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Fatal mucormycosis and aspergillosis coinfection associated with haemophagocytic lymphohistiocytosis: A case report and literature review - 17/03/23

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