Invasive Mucormycosis Involving the Laryngopharynx After Bone Marrow Transplantation.

J Craniofac Surg

Department of Otolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.

Published: May 2022

AI Article Synopsis

  • Invasive larynx or pharyngeal fungal infections are uncommon, but a case of invasive fungal laryngopharyngitis arose in a patient post bone marrow and stem cell transplant.
  • Antifungal treatments, including gargles and liposomal amphotericin B, were initiated after a biopsy suggested mucormycosis, leading to significant surgical interventions.
  • The patient showed no signs of recurrence after 9 months, highlighting the critical need for rapid diagnosis and aggressive management in immunocompromised individuals facing this dangerous infection.

Article Abstract

Invasive larynx or pharyngeal fungal infections are rare. We report an invasive fungal laryngopharyngitis patient who complained of a persistent sore throat after an allogenic bone marrow transplant and a haploidentical stem cell transplant. An antifungal gargle was used after finding necrotic changes extending from the right soft palate to the aryepiglottic fold. Biopsy and culture suggested a fungal infection with suspicious mucormycosis. imaging showed the right oropharynx, supraglottis, and the para- pharnygeal space were involved. After initiating liposomal amphotericin В for 4 days, wide excisional debridement, and a partial pharyngectomy with an anterolateral thigh free flap including the deep fascia were performed. Amphotericin B and posaconazole were used subsequently. Pathology assessment indicated invasive mucormycosis. There was no recurrence for 9 months. Mucormycosis is a fatal opportunistic infection often seen in immunocompromised patients. Rapid detection, radical resection, and reconstruction can save the patient from a life-threatening fungal infection of the laryngopharynx.

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Source
http://dx.doi.org/10.1097/SCS.0000000000008167DOI Listing

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