Issue: 2009 > January > case report

Disseminated <i>Rhizopus microsporus</i> infection in a patient on oral corticosteroid treatment: a case report

P. de Mol, J.F.G.M. Meis


A 71-year-old male with mild steroid-induced hyperglycaemia was diagnosed with a lethal invasive
<i>Rhizopus microsporus</i> infection. Disseminated zygomycosis is a rare entity and is most frequently found in neutropenic patients with haematological malignancies, post-transplants or in patients on deferoxamine therapy. Infection is characterised by tissue infarction and necrosis due to angioinvasive hyphae. Culture of <i>Zygomycetes</i> is necessary for species determination but histology is a must to prove the infection. Ante-mortem diagnosis and culture
is challenging and therefore mortality approaches 100%. Apart from amphotericine B, most anti-fungals have no activity against <i>Zygomycetes</i> but posaconazole
might offer new possibilities as a first-line agent. Timely
diagnosis, rapid surgery of infected tissue, correction
of underlying disorders and correct anti-fungal therapy
might be life-saving. Due to the increasing use of potent
immunosuppression, stem cell and organ transplants
and possibly selection for <i>Zygomycetes</i> by prior treatment with broad-spectrum antifungal therapy, the incidence of zygomycosis is rising. Therefore, clinicians might encounter an increasing number of zygomycosis cases in the near future.