Disseminated mucormycosis (zygomycosis) in acute myeloid leukemia.

A 50-year-old non-diabetic woman was admitted for hemorrhagic diathesis. Laboratory examination indicated that she was suffering from t(15;17)-positive acute promyelocytic leukemia associated with disseminated intravascular coagulation. She was started on all-trans retinoic acid plus idarubicin and cytarabine. However, due to the development of retinoic acid syndrome, all-trans retinoic acid was suspended and dexamethasone was begun. Leukemic promyelocytes disappeared from the peripheral blood and bone marrow but there was prolonged neutropenia. After 3 weeks, she developed rapidly progressive pneumonia recalcitrant to antibacterial and antifungal (micafungin) agents (Fig. 1) and died of respiratory failure on day 24. Blood culture was negative for fungi. Postmortem examination revealed disseminated mucormycosis involving the