Invasive Fungal Rhinosinusitis Due to Co-infection with Mucormycosis and Exserohilum rostratum in a Patient with Acute Lymphoblastic Leukemia

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Radici, Vera | Brissot, Eolia | Chartier, Suzanne | Guitard, Juliette | Fabiani, Bettina | Memoli, Mara | Banet, Anne | Heuberger, Laurence | Lapusan, Simona | Atallah, Sarah | Legrand, Ollivier | Genthon, Alexis

Edité par CCSD ; Atlantis Press International -

International audience. Abstract Invasive fungal infections remain an important cause of complication and morbidity in the management of acute leukemias. Here we report the case of a 27-year-old patient from French Polynesia who was diagnosed with Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia. After induction chemotherapy, she developed rhinosinusitis with extensive bone lysis. The context and clinical presentation quickly made us suspect an invasive mucormycosis infection. However, a multidisciplinary investigation including mass spectrometry techniques also revealed the presence of Exserohilum rostratum , a pathogen member of the genus Exserohilum that is ubiquitous in tropical and subtropical regions but rarely implicated in invasive sinusitis. Antifungal treatment combined with an early surgical approach resulted in a favorable clinical response.

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