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Phycomycosis Complicating Leukemia and Lymphoma

RICHARD D. MEYER, M.D.; PETER ROSEN, M.D.; and DONALD ARMSTRONG, M.D., F.A.C.P.
[+] Article and Author Information

Supported in part by Clinical Investigation Grant 26, American Cancer Society, New York, N.Y. Dr. Meyer was supported by Clinical Research Traineeship Grant CA-05110-09, National Cancer Institute, National Institutes of Health, Bethesda, Md.

Presented in part 29 September 1972, Interscience Conference on Antimicrobial Agents and Chemotherapy, Atlantic City, N.J.

▸Requests for reprints should be addressed to Donald Armstrong, M.D., Memorial Hospital, 444 East 68th St., New York, N.Y. 10021.


New York, New York


Ann Intern Med. 1972;77(6):871-879. doi:10.7326/0003-4819-77-6-871
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During the 10-year period from 1962 to 1971, 26 cases of phycomycosis were diagnosed at Memorial Hospital, New York. This large series enables us to report a significant increase in the incidence of phycomycosis at autopsy. Unlike our experience with aspergillosis, phycomycosis occurred only in patients with leukemias and lymphomas and not in those with carcinomas. Leukopenia was commoner in patients with leukemia and diabetes mellitus with lymphomas. The hallmark of infection was vascular invasion and infarction. Pulmonary involvement was present in 21 of 26 patients. Unusual presentations of phycomycosis included rhinocerebral infection without diabetes mellitus, cavitary pneumonia, and renal vein thrombosis. The commonest suggestive clinical pattern was fever and development or progression of pulmonary infiltrates despite antibiotic therapy. Premortem cultures were uniformly negative. None of the patients survived; suspicion of phycomycosis and earlier diagnosis is discussed in the hope that effective treatment can be given in the immunosuppressed patient.

Topics

leukemia ; lymphoma

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