The infectious thyroid nodule: a case report of mucormycosis associated with ibrutinib therapy

J Otolaryngol Head Neck Surg. 2019 Oct 16;48(1):49. doi: 10.1186/s40463-019-0376-1.

Abstract

Background: Acute invasive fungal infections of the head and neck secondary to tyrosine kinase inhibitors are rare and potentially life-threatening events.

Case presentation: We report a case of mucormycosis of the thyroid gland in a patient known for chronic lymphocytic leukemia receiving ibrutinib who presented with a rapidly growing thyroid nodule and dysphonia. An acute invasive fungal infection was identified on a core needle biopsy; mucormycosis was confirmed on culture. The patient was successfully treated with surgical debridement and long-term antifungal therapy.

Conclusion: Patients on ibrutinib may be at risk of acute invasive fungal infections of the head and neck.

Keywords: Acute invasive fungal infection; Ibrutinib; Mucormycosis; Thyroid nodule.

Publication types

  • Case Reports

MeSH terms

  • Adenine / analogs & derivatives
  • Agammaglobulinaemia Tyrosine Kinase / antagonists & inhibitors*
  • Aged
  • Cunninghamella / isolation & purification
  • Humans
  • Immunocompromised Host
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Male
  • Mucormycosis / etiology*
  • Piperidines
  • Pyrazoles / adverse effects*
  • Pyrazoles / therapeutic use
  • Pyrimidines / adverse effects*
  • Pyrimidines / therapeutic use
  • Thyroid Nodule / etiology*
  • Thyroid Nodule / microbiology
  • Thyroid Nodule / pathology

Substances

  • Piperidines
  • Pyrazoles
  • Pyrimidines
  • ibrutinib
  • Agammaglobulinaemia Tyrosine Kinase
  • BTK protein, human
  • Adenine

Supplementary concepts

  • Cunninghamella bertholletiae infection