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An atypical case of fatal zygomycosis: Simultaneous cutaneous and laryngeal infection in a patient with a non-neutropenic solid prostatic tumor

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March 1, 2008
by Kristine E. Johnson, MD, Kevin Leahy, MD, PhD, Christopher Owens, MD, Joel N. Blankson, MD, PhD, William G. Merz, PhD, and Bradley J. Goldstein, MD, PhD


We describe what we believe is the first reported case of simultaneous highly invasive cutaneous and laryngopharyngeal zygomycosis in a non-neutropenic, nondiabetic but immunosuppressed patient with prostate cancer. An invasive fungal process was not suspected until late in the patient's hospital course; when it was, a tracheotomy and direct laryngoscopic biopsies were performed. Unresectable invasive zygomycosis with Rhizopus rhizopodiformis was diagnosed. The patient was managed with liposomal amphotericin B initially and later with palliative medical therapy until he died. This case emphasizes the need for a rapid and specific diagnosis with timely introduction of appropriate antifungal management, particularly now that voriconazole is frequently used as empiric prophy-laxis against aspergillosis in high-risk patients.

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