INFECTIONS DUE TO CUNNINGHAMELLA-BERTHOLLETIAE IN PATIENTS WITH CANCER - REPORT OF 3 CASES AND REVIEW

Limited information is available regarding the pathogenesis and clinic al manifestations of infection with Cunninghamella bertholletiae. In t his report, we describe the clinical courses of three patients with le ukemia and fatal C. bertholletiae infection and review the literature. In all patients, the infection developed in the setting of severe neu tropenia following high doses of cytotoxic chemotherapy. Clinical pres entation always consisted of fever and pneumonia and could be associat ed with dissemination to numerous organs. The course of infection was very rapid, and the diagnosis was made around or after the time of dea th. The most important risk factors for C. bertholletiae infection des cribed in the literature include corticosteroid administration and pro longed severe granulocytopenia. Four infectious syndromes due to Zygom ycetes have been described: rhinocerebral, pulmonary, cutaneous and so ft tissue, and disseminated. The outcome of disseminated infection wit h C. bertholletiae has been almost uniformly fatal. Most previously de scribed patients, however, did not receive aggressive treatment consis ting of amphotericin B administration, resection of infected tissues, and, most importantly, control of the underlying disease.