Abstract: A 47-year-old male was admitted to hospital with acute myeloid leukemia (AML). During chemotherapy he had high fever, upper right chest pain, swelling and pain of the right wrist after giving a PICC placement. During 12 days, the swelling area of the right forearm muscle tissue gradually expanded, accompanied by swelling and numbness of the right thumb and index finger. A variety of antibiotics were given successively, but the therapeutic effect failed to improve, and the high fever continued. The blood, muscle tissue and sputum samples were examined using metagenomic next-generation sequencing (mNGS). The mNGS assay revealed the pathogen presence of Rhizomucor pusillus. Once targeted antibiotic therapy with amphotericin B, liposomal amphotericin B(AmBisome), and posaconazole were administered, the infection was controlled.

Key words: acute myeloid leukemia, mucormycosis, metagenomic next-generation sequencing