Combined anti-fungal therapy and surgical resection as treatment of pulmonary zygomycosis in allogeneic bone marrow transplantation

Opportunistic fungal infection is a rare but severe complication in allogen eic bone marrow transplant (BMT) recipients. We report a 19-year-old patien t who developed pneumonitis after BMT, due to a Mucorales fungus (class Zyg omycetes), Absidia corymbifera. Infections due to mucormycosis are likely t o become increasingly recognized even though the occurrence after BR;IT has only been described sporadically. We postulate that the patient was contam inated before BMT despite no intensive drug treatment or other iatrogenic f eatures, related to his poor living conditions and developed the infection during aplasia, He immediately received i.v. liposomal amphotericin B (AmBi some) and GM-CSF. Because there was no response, the infected area and necr otic tissue were resected, Despite initial clinical and biological improvem ent and the absence of Mucor on mycological examination post-surgery, the p atient died 3 weeks later from bilateral pulmonary infection and multiorgan failure.