Cure of Pulmonary Rhizomucor Pusillus Infection in a Patient with Hairy-Cell Leukemia: Role of Liposomal Amphotericin B and GM-CSF

Abstract

We describe a case of successfully treated multifocal pulmonary Rhizomucor pusillus, a condition which has previously been universally fatal. A 77 year-old man had a background of chronic neutropenia due to hairy-cell leukemia, splenectomy, corticosteroid therapy and an obstructing left ureteric transitional-cell carcinoma. He was successfully treated with 3 months of high-dose liposomal amphotericin B and 7 months of granulocyte-macrophage colony-stimulating factor. Treatment was complicated by mild reversible deterioration of renal function. There was a near complete radiological response to the therapy at 6 months and the patient remains well 20 months following diagnosis of R. pusillus and 13 months following cessation of treatment.

Key Words:

• Rhizomucor pusillus
• pulmonary mucor
• zygomycosis
• liposomal amphotericin B
• granulocyte-macrophage stimulating factor
• hairy cell leukemia