71-Year-Old Patient with Chronic Lymphocytic Leukemia (CLL) and Hypoechoic Nodular Spleen and Liver Lesions with Fatal Outcome: Presentation of Mucormycosis in B-Mode Imaging and Contrast-Enhanced Ultrasound (CEUS)

Introduction

Mucormycosis is a fungal infection that can potentially manifest in any organ system. It mainly affects immunocompromised patients with diabetes mellitus type II or malignant hematologic diseases, especially after stem cell transplantation [1] [2]. In a study of 929 patients facing zygomycosis, infestation of the sinus cavities (39%) was observed most frequently, followed by pulmonary (24%) and cutaneous manifestations (19%) [1]. However, mucormycosis of the liver and spleen is rare and has been documented only in several case reports [3].

Contrast-enhanced ultrasound (CEUS) is an established and important method for the diagnosis of focal liver lesions. The first guidelines for CEUS of the liver were published in 2004, followed by updates in 2008 and 2012 [4]. CEUS imaging of mucormycosis has not been described in the literature. To our knowledge, this case report describes hepatic and splenic mucormycosis using CEUS for the first time.

• References

• 1 Roden MM, Zaoutis TE, Buchanan WL et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis 2005; 41: 634-653
• 2 Lanternier F, Dannaoui E, Morizot G et al. A global analysis of mucormycosis in France: the RetroZygo Study (2005–2007). Clin Infect Dis 2012; 54 (Suppl. 01) S35-S43
• 3 Khan AA, Kumaran V, Jain D et al. Hepatic mucormycosis in a patient of acute lymphoblastic leukemia: a case report with literature review. Indian J Hematol Blood Transfus 2013; 29: 96-98
• 4 Claudon M, Dietrich CF, Choi BI et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver – update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med 2013; 34: 11-29
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