Fungemia caused by Mucor circinelloides species complex in a patient with bladder cancer: A rare case report Mesane kanserli bir hastada Mucor circinelloides tür kompleksi kaynaklı fungemi: Nadir bir olgu sunumu

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Ezer B., Ceylan A., Arazi Kan S. N., Uğrakli S., Bulut R.

Turk Hijyen ve Deneysel Biyoloji Dergisi, cilt.83, sa.2, ss.163-168, 2026 (Scopus, TRDizin)

Özet

Mucormycosis is a rapidly progressive fungal infection associated with high mortality and morbidity caused by fungi belonging to the class Zygomycetes. The most common causative agents are Rhizopus spp., Mucor spp., and Lichtheimia spp. Risk factors for mucormycosis include immunosuppression, neutropenia, conditions that impair skin integrity (such as burns, surgical wounds), deferoxamine therapy and corticosteroid therapy, and voriconazole prophylaxis. Among these, uncontrolled diabetes mellitus is one of the most important risk factors. Rhinocerebral involvement is more common in patients with diabetes mellitus, whereas pulmonary or disseminated mucormycosis and fungemia are more commonly observed in patients with malignancy and neutropenia. In this case, a patient with bladder cancer was admitted to the intensive care unit due to clinical and laboratory findings including elevated levels of C-reactive protein (CRP), procalcitonin, and serum lactate. After obtaining two sets of peripheral venous blood cultures, empirical intravenous antibiotic therapy was initiated with a preliminary diagnosis of septic shock. Blood cultures were inoculated onto sheep blood agar, Eosin Methylene Blue (EMB) agar, and Sabouraud Dextrose Agar (SDA). Following incubation, the molds grown in culture were identified by Sanger sequencing using ITS1 (5'-TCCGTAGGTGAACCTGCGG-3') and ITS4 (5'-TCCTCCGCTTATTGATATGC-3') primers on the Applied Biosystems™ ProFlex thermal cycler (California, USA). The obtained sequences were analyzed using BLAST database, and the causative agent was identified as Mucor circinelloides species complex. According to antifungal susceptibility test results, intravenous liposomal amphotericin B therapy was initiated. Although no growth was detected in the control blood culture on the fourth day of antifungal treatment, the patient died on the tenth day of hospitalization. Cases of Mucor circinelloides fungemia confirmed by sequencing are limited in the literature. This case report aimed to present the clinical and microbiological features of a fungemia case caused by the Mucor circinelloides species complex.