Successful treatment of probable disseminated mucormycosis using liposomal amphotericin B and isavuconazole in myelodysplastic syndrome: A case report and literature review

Int J Infect Dis. 2026 Mar:164:108394. doi: 10.1016/j.ijid.2026.108394. Epub 2026 Jan 14.

Abstract

Background: Mucormycosis is a rare, aggressive, and life-threatening fungal infection that predominantly affects immunocompromised individuals and is associated with a high mortality rate.

Case presentation: We treated a 72-year-old woman with myelodysplastic syndrome (MDS) who developed disseminated mucormycosis involving the lungs, skin, and central nervous system (CNS). Diagnosis was supported by metagenomic next-generation sequencing (mNGS), and she received combination antifungal therapy with liposomal amphotericin B and isavuconazole. Her clinical status stabilized after 4 weeks of treatment. She later died approximately 2 weeks after discharge because of carbapenem-resistant Pseudomonas aeruginosa bacteremia.

Conclusions: Our case highlights the importance of prompt diagnosis and timely initiation of therapy for mucormycosis and indicates that combination antifungal therapy may be an effective approach to managing severe disseminated mucormycosis in immunocompromised patients.

Keywords: Combination antifungal therapy; Disseminated mucormycosis; Isavuconazole; Liposomal amphotericin B; Metagenomic next-generation sequencing; Myelodysplastic syndrome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Amphotericin B* / therapeutic use
  • Antifungal Agents* / administration & dosage
  • Antifungal Agents* / therapeutic use
  • Drug Therapy, Combination
  • Fatal Outcome
  • Female
  • Humans
  • Immunocompromised Host
  • Mucormycosis* / complications
  • Mucormycosis* / diagnosis
  • Mucormycosis* / drug therapy
  • Myelodysplastic Syndromes* / complications
  • Nitriles* / therapeutic use
  • Pyridines* / administration & dosage
  • Pyridines* / therapeutic use
  • Treatment Outcome
  • Triazoles* / therapeutic use

Substances

  • isavuconazole
  • Antifungal Agents
  • Amphotericin B
  • Pyridines
  • Triazoles
  • liposomal amphotericin B
  • Nitriles