Development of a quantitative PCR detecting Cunninghamella bertholletiae to help in diagnosing this rare and aggressive mucormycosis

Mucormycosis is an invasive mold infection, frequently fatal in immunocompromised patients. We report the case of a patient with chronic lymphocytic leukemia admitted to the hematology unit for febrile aplasia. Pulmonary lesions suggesting a fungal infection expanded/increased despite a combination...

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Published inBone marrow transplantation (Basingstoke) Vol. 53; no. 9; pp. 1180 - 1183
Main Authors Bellanger, Anne-Pauline, Berceanu, Ana, Rocchi, Steffi, Valot, Benoit, Fontan, Jean, Chauchet, Adrien, Belin, Nicolas, Scherer, Emeline, Deconinck, Eric, Navellou, Jean-Christophe, Millon, Laurence
Format Journal Article
LanguageEnglish
Published England Nature Publishing Group 01.09.2018
Subjects
Amphotericin B
Antifungal agents
Antiparasitic agents
Aplasia
Biological markers
Biomarkers
Biopsy
Bone marrow
Cancer treatment
Care and treatment
Chemotherapy
Chronic lymphocytic leukemia
Cunninghamella bertholletiae
Development and progression
Ecology, environment
Fatalities
Fungal infections
Fungi
Fungicides
Genetic aspects
Genotypes
Health
Hematology
Identification and classification
Immunocompromised host
Immunocompromised hosts
Infections
Innovations
Invasiveness
Leukemia
Life Sciences
Lung diseases
Lymphatic leukemia
Lymphocytic leukemia
Molecular diagnostic techniques
Mucormycosis
Mycoses
Polymerase chain reaction
Posaconazole
Pulmonary lesions
Stem cell transplantation
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Summary:Mucormycosis is an invasive mold infection, frequently fatal in immunocompromised patients. We report the case of a patient with chronic lymphocytic leukemia admitted to the hematology unit for febrile aplasia. Pulmonary lesions suggesting a fungal infection expanded/increased despite a combination of posaconazole and liposomal amphotericin B. The fungal biomarkers performed repeatedly were negative. At D65 after chemotherapy a bronchial biopsy was positive for Cunninghamella bertholletiae. The patient died despite appropriate antifungal management. A qPCR targeting Cunninghamella was developed a posteriori, and a retrospective analysis showed that a sample was positive more than 30 days before culture-based identification could be made.
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ISSN:0268-3369
1476-5365
DOI:10.1038/s41409-018-0194-5