Alveolo-pleural fistula is a common complication of severe pulmonary infection. Some patients require long-term placement of chest tubes until spontaneous closure of the fistula takes place, whereas others require surgical intervention. We report a case of a patient with alveolo-pleural fistula secondary to Pneumocystis jirovecii pneumonia who was successfully treated with the use of intrabronchial unidirectional valves inserted using flexible bronchoscopy.

Mucormycosis is a rare complication in cancer patients. This report presents the case of a acute myeloblastic leukemia patient who developed an ascending paralysis due to disseminated mucormycosis. The presentation was unusual because the early symptoms were fever and pain, and the disease was misdiagnosed because of a concomitant infection by Enterococcus faecium. CASE REPORTA 70-year-old female was admitted to our hospital for acute myeloblastic leukemia (French-American-British type M1). On day 4 after induction chemotherapy, during the treatmentrelated aplasia, the patient became febrile, and Staphylococcus epidermidis and Staphylococcus mitis were detected in blood cultures. She was given antibiotics (ceftazidime and amikacin), and the fever rapidly resolved. On day 11, the patient presented a right flank pain that, in the following days, spread into the lumbar region bilaterally, with a band irradiation in the upper abdomen. At this time there was no evidence, either clinically or in the chest X ray or in the echo tomography of the kidney and liver, of any localized infection. On day 16, the patient presented again high fever and abruptly developed an acute paraplegia, which rapidly became an ascending paralysis. The lumbar pain was still present, and it extended to each thigh's anterior surface, with hyperesthesia and numbness in the legs. Nuclear magnetic resonance imaging of the spinal marrow showed altered T1-T2 signal intensity between D12 and L1, suggestive of an edematous ischemic lesion. Blood and spinal fluid cultures at that time were positive for Enterococcus