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

Bone Marrow Transplant. 2018 Sep;53(9):1180-1183. doi: 10.1038/s41409-018-0194-5. Epub 2018 Apr 30.

Abstract

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / therapeutic use
  • Cunninghamella / isolation & purification*
  • Fatal Outcome
  • Humans
  • Immunocompromised Host
  • Leukemia, Lymphocytic, Chronic, B-Cell / microbiology
  • Lung / microbiology
  • Male
  • Mucormycosis / diagnosis*
  • Real-Time Polymerase Chain Reaction / methods*

Substances

  • Antifungal Agents