# Disseminated Lomentospora prolificans infection in a neutropenic patient with acute monocytic leukemia: a clinical and diagnostic challenge

## TL;DR

A patient with leukemia developed a deadly fungal infection that is hard to treat, showing the need for better diagnostics and therapies.

## Contribution

This case report highlights the diagnostic and therapeutic challenges of disseminated Lomentospora prolificans infection in immunocompromised patients.

## Key findings

- L. prolificans infection in a neutropenic leukemia patient led to rapid progression despite standard antimicrobials.
- Blood cultures confirmed the infection, but treatment was ineffective.
- The case emphasizes the need for novel antifungal agents and improved diagnostic techniques.

## Abstract

Lomentospora prolificans is an opportunistic fungal
pathogen associated with significant morbidity and mortality in
immunocompromised individuals. Its intrinsic resistance to most
antifungal agents poses challenges in clinical management, particularly
in patients with hematological malignancies.

Herein, we report the case of a 60-year-old male with recently diagnosed
acute monocytic leukemia who developed a disseminated L.
prolificans infection during induction chemotherapy.
Despite standard prophylactic antimicrobials, the patient experienced
febrile neutropenia, progressive pulmonary findings, and neurological
complications, culminating in disseminated fungal infection. Blood
cultures confirmed the diagnosis, and antifungal therapy was promptly
expanded. However, the infection progressed rapidly, and the patient
died despite aggressive therapeutic interventions.

This case highlights the complexities of diagnosing and treating
L. prolificans infections in profoundly
immunosuppressed patients. It underscores the importance of heightened
clinical suspicion, early recognition, aggressive management, and the
need for continued development of novel antifungal agents and diagnostic
techniques.