Cryptic Mucor infection leading to massive cerebral infarction at initiation of antileukemic chemotherapy

A 74-year-old man with newly diagnosed acute myelogenous leukemia unexpecte dly suffered a massive cerebral infarct on day 2 of induction chemotherapy, Clinically, the hemorrhagic infarct was thought to be due to leukostasis a nd thrombocytopenia. Necropsy. however, revealed that Zygomycetes-type hyph ae had infiltrated cerebral vessels in and near the infarct, The fungal inf ection was clinically silent otherwise, although fungal elements were also identified in the lung at autopsy, This case illustrates how closely fungal infection may resemble a leukemia-associated cerebrovascular accident.