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Rhizopus presenting as an endobronchial obstruction following bone marrow transplant

Bone Marrow Transplantation volume 28, pages 634–636 (2001)Cite this article

The Zygomycetes are a group of fungi found commonly in the soil and in decaying organic matter. Family members that infect humans include Mucor, Rhizopus, Absidia, and Cunninghamella species.1,2 These spore-forming saprophytes can infect humans by inhalation of aerosolized spores. Although rare cases of zygomycete infection have been reported in immunocompetent subjects, the overwhelming majority occur in immunocompromised patients. We report a case of an endobronchial obstructing lesion due to Rhizopus that proved fatal in a patient who had recently undergone umbilical cord blood transplant.

A 44-year-old man was admitted to the hospital to undergo umbilical cord blood transplant. Eight months prior to transplant he presented with pancytopenia and was diagnosed with M4 AML. His induction regimen included Ara-C and indarubicin. His course was complicated by vancomycin-resistant enterococcal bacteremia, which was treated with quinupristin/dalfopristin. A subsequent bone marrow aspirate demonstrated persistent blasts and further attempts at re-induction chemotherapy failed. The patient had no matching siblings and was deemed not to be a candidate for autologous transplantation due to failure to mobilize an adequate number of CD34+ cells. Ultimately, the patient presented to our institution to undergo an unrelated umbilical cord blood transplant.

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Acknowledgements

This work was funded in part by National Institutes of Health Grants HL55166.

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Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC 27710, USA

    L Maddox & RJ Folz

  2. Duke University Adult Bone Marrow and Stem Cell Transplant Program, Duke University Medical Center, Durham, NC 27710, USA

    GD Long & JJ Vredenburgh

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  1. L Maddox
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  2. GD Long
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  3. JJ Vredenburgh
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  4. RJ Folz
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Maddox, L., Long, G., Vredenburgh, J. et al. Rhizopus presenting as an endobronchial obstruction following bone marrow transplant. Bone Marrow Transplant 28, 634–636 (2001). https://doi.org/10.1038/sj.bmt.1703191

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