Endotracheal Actinomycosis Combined with Mucormycosis: A Case Report and Literature Review

Abstract

Background: Actinomycosis and mucormycosis are very uncommon in clinical work, a combination of both two infection is much rarer in one host. Actinomycosis of the trachea is a chronic septic disease caused by an actinomycete infection with a very low incidence. It is easily misdiagnosed owing to the difficulty in obtaining microbiological evidence. Likewise, mucormycosis is a rare conditionally pathogenic invasive fungal infection, but with an abrupt start, quick progression, and extremely high mortality. It is frequently observed in individuals with immunosuppression-related disorders. The infection is rare in one host with both of the two above pathogens, and the site of infection involving only the main bronchi is even more uncommon, which is why we report the following case. Case description: The patient, a 58-year-old lady, has a long history of diabetes and has trouble controlling her blood sugar. A whitish mass in the main bronchus was discovered via fiberoptic bronchoscopy as a result of breathing difficulties. Then, the diagnosis of complex intratracheal actinomycosis with mucor infection was supported by a pathological biopsy. After an active combination treatment with bronchoscopic cryotherapy, Holmium Laser coupled with amphotericin B and penicillin, the patient was successfully discharged. Conclusions: Clinically, when imaging reveals intratracheal protuberant lesions, further fiberoptic bronchoscopy and an etiological investigation should be carried out as soon as feasible in order to prevent misdiagnosis and missed diagnosis.