Luo Bing Qing, Tan Xiao Yan, Chen Ying, Chen Lin
Department of Hematology, The Second Affiliated Hospital, Chongqing Medical University, Jiangnan, Chongqing, China.
J Med Cases. 2025 Jan;16(1):23-27. doi: 10.14740/jmc5042. Epub 2024 Nov 23.
Mucormycosis is a rare but fatal opportunistic fungal infection. Patients with hematologic malignancies who use immunosuppressant and glucocorticoid extensively are susceptible to mucormycosis. We report a case of an older patient with acute myeloid leukemia (AML) who was infected with pulmonary mucormycosis during chemotherapy. With a good balance of chemotherapy-induced myelosuppression and control of Mucorales infection, the patient got a complete remission of leukemia by the combination of azacitidine and venetoclax, and pulmonary mucormycosis was well controlled. But due to poor compliance, the patient died of asphyxiation as a result of aspiration of pulmonary necrosis-like substances after discharge. To our knowledge, this is the first case report of an older patient with AML complicated with pulmonary mucormycosis dying of asphyxia from pulmonary necrosis-like substances. Our article seeks to raise awareness of proper precautions to be taken in the management mucormycosis.
毛霉病是一种罕见但致命的机会性真菌感染。广泛使用免疫抑制剂和糖皮质激素的血液系统恶性肿瘤患者易患毛霉病。我们报告一例老年急性髓系白血病（AML）患者，在化疗期间感染了肺部毛霉病。通过阿扎胞苷和维奈克拉联合使用，在化疗引起的骨髓抑制与毛霉目感染控制之间取得良好平衡，患者白血病完全缓解，肺部毛霉病也得到良好控制。但由于依从性差，患者出院后因吸入肺部坏死样物质导致窒息死亡。据我们所知，这是首例老年AML合并肺部毛霉病患者因肺部坏死样物质窒息死亡的病例报告。我们的文章旨在提高对毛霉病管理中应采取适当预防措施的认识。
