• Xavier Boumaza, Lucie Lelièvre, Sarah Guenounou, Cécile Borel, Anne Huynh, Guillaume Beziat, Karen Delavigne, Damien Guinault, Marie Garric, Marie Piel-Julian, Kim Paricaud, Guillaume Moulis, Leonardo Astudillo, Laurent Sailler, Dominique Farge, and Grégory Pugnet.
• Department of Internal Medicine.
• Medicine (Baltimore). 2020 Jul 31; 99 (31): e21431e21431.

RationaleThe use of autologous hematopoietic stem cell transplantation (AHSCT) for autoimmune diseases has become the first indication for transplant in nonmalignant disease. Mucormycosis is a rare invasive infection with increasing incidence in patients treated with AHSCT. We report the first case of pulmonary mucormycosis following AHSCT for systemic sclerosis (SSc).Patient ConcernsA 24-year-old woman with rapidly progressive diffuse cutaneous SSc presented with an acute respiratory distress syndrome 6 days after AHSCT.DiagnosesThe results of clinical and computed tomography scan were consistent with pulmonary mucormycosis and the diagnosis was confirmed by a positive Mucorales Polymerase Chain Reaction on a peripheral blood sample.Interventions And OutcomesEarly antifungal therapy by intravenous amphotericin B provided rapid improvement within 4 days and sustained recovery after 2 years of follow-up.LessonsWith the progressively increasing use of AHSCT and other stem cell therapy for treatment of severe SSc and other autoimmune diseases, the potential onset of rare post-transplant fungal infections, such as mucormycosis, requires careful patient monitoring and better awareness of early initiation of adequate therapy.

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