Fatal mucormycosis and aspergillosis coinfection associated with haemophagocytic lymphohistiocytosis: A case report and literature review
Dorian Loubet, Benjamine Sarton, Lucie Lelièvre, Gaspard Grouteau, Xavier Iriart, Pamela Chauvin, Judith Fillaux, Alexis Valentin, Antoine Berry, Stein Silva, Fabrice Bonneville, Sophie Cassaing, Emilie Guémas
Abstract
Invasive mould infections are life-threatening and mainly occur in immunocompromised patients. Whereas aspergillosis is described during haemophagocytic lymphohistiocytosis (HLH), only a few cases of concomitant mucormycosis with HLH have been reported. Here, we present an uncommon coinfection of mucormycosis and aspergillosis associated with HLH probably due to a varicella zoster virus (VZV) viraemia which was unresponsive to triple antifungal therapy (liposomal amphotericin B combined with isavuconazole and caspofungin). A review of the cases of mucormycosis with HLH showed that this uncommon association was always lethal and underscored the relevance of screening for mould infections in patients with HLH.