A case report of successful treatment of pulmonary mucormycosis caused by Cunninghamella bertholletiae infection in a patient with T-lymphoblastic lymphoma

Abstract

Mucormycosis caused by Cunninghamella bertholletiae (C. bertholletiae) is a rare opportunistic infection in patients with hematological malignancies (HM), with high mortality rates. Herein, we first report a case of pulmonary mucormycosis (PM) with C. bertholletiae in a 25-year-old male recently diagnosed with T-lymphoblastic lymphoma (T-LBL). The diagnosis was established through chest computed tomography (CT), metagenomic next-generation sequencing (mNGS) of blood and bronchoalveolar lavage fluid (BALF), as well as histopathological examination. Hematoxylin and eosin (HE) staining of the surgical specimen revealed the presence of fungal hyphae. He was effectively treated with liposomal amphotericin B (L-AmB) and posaconazole enteric-coated tablets, followed by aggressive surgical debridement. In our case, the fungal infection was initially identified as C. bertholletiae using mNGS, which facilitated rapid and accurate diagnosis, enabling clinicians to initiate early intensive treatment. The case also emphasizes the importance of surgical debridement in addressing affected tissues and underscores the significance of a multidisciplinary approach in implementing this treatment strategy.

Keywords

• Pulmonary mucormycosis
• Cunninghamella bertholletiae
• Metagenomic next-generation sequencing
• T-lymphoblastic lymphoma
• Case report