Institutional members access full text with Ovid®

Share this article on:

Angioinvasion by Cunninghamella as a Cause of Anterior Spinal Artery Syndrome in an Immunocompromised Patient

Engskow, Danielle G., MD*; Nanjappa, Sowmya, MD†‡; Tran, Nam D., MD, PhD§; Sandin, Ramon L., MD, MS, FCAP*∥¶; Greene, John N., MD, FACP

Infectious Diseases in Clinical Practice: July 2018 - Volume 26 - Issue 4 - p 228–231
doi: 10.1097/IPC.0000000000000555
Case Reports

Cunninghamella bertholletiae is an opportunistic fungi species in the order Mucorales that almost exclusively affects immunocompromised hosts. It is highly invasive and is well known for angioinvasion of surrounding vasculature. We describe a case of pulmonary Cunninghamella infection with dissemination and invasion of the anterior spinal artery causing anterior spinal artery syndrome.

This case describes a neutropenic patient with relapsed acute myeloid leukemia status post hematopoietic stem cell transplantation-matched unrelated donor who developed pulmonary Cunninghamella that disseminated and invaded the anterior spinal artery causing anterior spinal artery syndrome as well as black, necrotic buttock lesions. This case report demonstrates the importance of considering fungi, especially Cunninghamella, as a cause of anterior spinal artery syndrome in immunocompromised patients.

From the *Infectious Division, Department of Internal Medicine, Morsani College of Medicine, University of South Florida;

Department of Internal Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute;

Departments of Oncologic Sciences and

§Oncology and Neurosurgery, Morsani College of Medicine, University of South Florida;

Clinical Microbiology and Virology Laboratories; and

H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.

Correspondence to: John N. Greene, MD, FACP, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, FOB-3, Tampa, FL 33612-9497. E-mail: john.greene@moffitt.org.

The authors have no funding or conflicts of interest to disclose.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.