fungal-infections-2017-posters-accepted-abstracts

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Microbiol Biotechnol Rep | Volume 1, Issue 2

November 16-17, 2017 Atlanta, Georgia, USA

Annual Congress on

Mycology and Fungal Infections

Invasive mucormycosis in chronic granulomatous disease

Abdulnasir Al-Otaibi

, Dayel Al-Shahrani

, Eman Al-Idrissi

and

Hail Al-Abdely

University of Toronto, Canada

King Fahad Medical City, Saudi Arabia

King Faisal Specialist Hospitals and Research Centre, Saudi Arabia

ucor

mycosis is an uncommon fungal infection caused by members of the order

Mucorales

. Populations

at risk for this potentially life-threatening infection include hematopoietic stem-cell transplant (HSCT)

recipients, patients with hematological malignancies, diabetes mellitus, ketoacidosis, burns, trauma, premature

neonates, and patients receiving iron chelation.

Rhizopus

is the most commonly identified species, followed by

Mucor

spp. Common patterns of mucormycosis are cutaneous, gastrointestinal, rhinocerebral, and pulmonary.

Amphotericin B is the antifungal drug of choice for treatment of mucormycosis. Combination polyene-

caspofungin treatment was found to be associated with improved survival in patients with rhino-orbital-

cerebral mucormycosis, compared to polyene monotherapy. Surgery is an important adjunctive therapy and

was shown to decrease mortality in patients with mucormycosis. We described rare presentations of pulmonary

mucormycosis caused by

Rhizopus

spp. in 2 patients with CGD; with chest wall and spinal involvement in a

child, and cardiovascular involvement in an adult patient. Case 1: A2-year-old girl presented with pneumonia and

pleural effusion that failed to respond to prolonged courses of broad spectrum antibiotics and pleural drainage.

Examination revealed a febrile, malnourished child with enlarged liver and spleen. Chest examination showed a

firm mass extending from the axial to the posterior aspect of the right chest wall. CT scan showed consolidation

involving right lower lobe, middle lobe, and posterior segment of the right upper lobe with pleural effusion. A

right chest wall mass with intraspinal extension was also noted. Cultures of tissue obtained from surgical biopsy

of the chest wall mass grew

Rhizopus

spp. She was subsequently diagnosed to have CGD based on oxidative

burst test result. Treatment with liposomal amphotericin B was initiated at a dose of 5 mg/kg/day then increased

to 7 mg/kg/day. Caspofungin and interferon γ (IFN-γ) were added to treatment. She underwent surgical debulking

of the chest wall mass and near-total pneumonectomy. She was then referred to a specialized center for HSCT.