Fatal mucormycosis and aspergillosis coinfection associated with haemophagocytic lymphohistiocytosis: A case report and literature review |
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| Affiliation: | 1. Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France;2. Critical Care Unit, University Hospital of Purpan, Toulouse, France;3. Toulouse NeuroImaging Center, Unité Mixte de Recherche 1214, Institut National de la Santé et de la Recherche Médicale, Université Paul Sabatier, Toulouse, France;4. Department of Infectious and Tropical Diseases, CHU Toulouse, Toulouse, France;5. PHARMA-Dev, UMR 152 IRD-UPS, Université Toulouse, France;6. Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France;7. Neuroradiology Department, Pierre-Paul-Riquet/Purpan University Hospital, Toulouse, France;8. RESTORE Institute, UMR 1301-Inserm 5070-CNRS EFS Univ. P. Sabatier, Toulouse, France |
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| Abstract: | Invasive mould infections are life-threatening and mainly occur in immunocompromised patients. Whereas aspergillosis is described during haemophagocytic lymphohistiocytosis (HLH), only a few cases of concomitant mucormycosis with HLH have been reported. Here, we present an uncommon coinfection of mucormycosis and aspergillosis associated with HLH probably due to a varicella zoster virus (VZV) viraemia which was unresponsive to triple antifungal therapy (liposomal amphotericin B combined with isavuconazole and caspofungin). A review of the cases of mucormycosis with HLH showed that this uncommon association was always lethal and underscored the relevance of screening for mould infections in patients with HLH. |
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