Combined medico-surgical strategy for invasive sino-orbito-cerebral breakthrough fungal infection with Hormographiella aspergillata in an acute leukaemia patient

M. Heiblig (1) , V. Bozzoli (1) , J. Saison (2) , X. Thomas (1) , D. de Croze (3) , A. Traverse-Glehen (3) , A. Cosmidis (4) , C. Chidiac (2) , Tristan Ferry (5, 2) , Alexandre Alanio (6, 7) , A. L. Bienvenu (8, 9) , Didier Dupont (9) , S. Ducastelle-Lepretre (1) , M. Michallet (1) , Florence Ader (2, 10) , Lyon Heminf Study Group

1 Service d’Hématologie [Centre Hospitalier Lyon Sud - HCL]
2 Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL]
3 Laboratoire d'anatomie et de cytopathologie - Centre hospitalier Lyon Sud
4 Service d’Otorhinolaryngologie [Centre Hospitalier Lyon Sud - HCL]
5 StaPath - Pathogénie des Staphylocoques – Staphylococcal Pathogenesis
6 Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris]
7 Mycologie moléculaire
8 SMITh - Synthèse de Molécules d'Intérêt Thérapeutique
9 Institut de parasitologie et mycologie médicale
10 LegioPath - Pathogenèse des légionelles- Legionella pathogenesis

Hormographiella aspergillata is a rare causative agent of invasive filamentous breakthrough infection, mostly arising after echinocandin exposure. We report a neutropenic patient who developed a severe sino-orbito-cerebral H. aspergillata infection while receiving empirical caspofungin, successfully controlled by an aggressive strategy associating surgical debridement and combined high-dose regimen of antifungal drugs.

Keywords: Molecular Sequence Data; basidiomycosis; Central Nervous System Fungal Infections; Combined Modality Therapy; Brain; Drug Resistance; Male; Fungal; Echinocandins; Antifungal Agents; Debridement; Agaricales; allogeneic haematopoietic stem cell transplantation; Acute; Leukemia; Fatal Outcome; Neutropenia; Myeloid; Hormographiella aspergillata; Humans; Young Adult; acute myeloid leukaemia

Domains: Life Sciences [q-bio]; Human health and pathology

M. Heiblig, V. Bozzoli, J. Saison, X. Thomas, D. de Croze, et al.. Combined medico-surgical strategy for invasive sino-orbito-cerebral breakthrough fungal infection with Hormographiella aspergillata in an acute leukaemia patient. Mycoses, 2015, 58 (5), pp.308--312. ⟨10.1111/myc.12305⟩. ⟨pasteur-01405220⟩