A Case of Fungal Sinusitis and Preseptal Cellulitis Caused by Lichtheimia corymbifera in a Patient with Acute Myeloid Leukemia Akut Miyeloid Lösemili Bir Hastada Lichtheimia corymbifera’nın Etken Olduğu Fungal Sinüzit ve Preseptal Selülit Olgusu
Mikrobiyoloji Bulteni, cilt.59, sa.4, ss.533-541, 2025 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 59 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.5578/mb.20250422
- Dergi Adı: Mikrobiyoloji Bulteni
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Central & Eastern European Academic Source (CEEAS), TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.533-541
- Anahtar Kelimeler: Lichtheimia corymbifera, Mucormycosis, Fungal infection, Acute myeloid leukemia, Sinusitis, Preseptal cellulitis
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Lichtheimia corymbifera (formerly known as Absidia corymbifera) is a mold fungus belonging to the family Mucorales. Mucormycosis caused by L.corymbifera is a newly recognized and rare opportunistic infection in immunocompromised patients. Rapid diagnosis and treatment are crucial due to the high mortality rates, especially in patients with hematologic malignancies. Early clinical suspicion, surgical removal of necrotic tissue and appropriate antifungal chemotherapy constitute the main steps of treatment. Lipid formulations of Amphotericin B are the first-line treatment for mucormycosis. In this report a case of fungal sinusitis and preseptal cellulitis caused by L.corymbifera in a 23-year-old male patient who had been followed for eight years with a diagnosis of acute myeloid leukemia (AML) was presented. The patient, hospitalized due to relapsed AML, development of edema and discharge in the left eye and ophthalmological evaluation revealed preseptal cellulitis. Despite treatment, no clinical improvement was observed and contrast-enhanced orbital and paranasal sinus computed tomography revealed sinusitis. Direct microscopic examination of crusted lesions from the left nasal cavity showed the presence of irregular aseptate hyphae. A panic notification was reported to the relevant clinic with a preliminary diagnosis of mucormycosis. After the clinic and the patient interview, liposomal Amphotericin B treatment was started since the patient did not accept surgical debridement. The material was cultured on two Sabouraud’s Dextrose agar; one was incubated at 22 °C (room temperature) and the other at 37 °C (incubator). On the second day of incubation at 37 °C, colony morphology was observed as light white woolly surfaces with a dark white, non-pigmented base. In the preparations prepared with lactophenol cotton blue; fixed stolons ending in a pyriform funnel-shaped apophysis supporting the sporangium were observed. The agent grown in culture was named to species level with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (MALDI Biotyper® Sirius System, Bruker, Germany) and diagnosed as L.corymbifera based on characteristic macroscopic and microscopic features. Although the patient refused surgical debridement treatment, early presumptive diagnosis allowed for the administration of liposomal Amphotericin B, resulting in successful treatment In conclusion, rapid preliminary diagnosis is critical to prevent the aggressive clinical course of mucormycosis, improves prognosis and increases survival rate.