Isolated pulmonary mucormycosis in an immunocompetent patient: a case report and systematic review of the literature

Abstract

Background Pulmonary mucormycosis caused by Mucorales is a highly lethal invasive fungal infection usually found in immunocompromised patients. Isolated pulmonary mucormycosis in immunocompetent patients is very rare. Here, we present a case of a 32-year-old male who developed pulmonary mucormycosis without any known immunodeficiency. Case presentation The patient presented to our hospital because of cough and chest pain along with blood in the sputum. He was first treated for community-acquired pneumonia until bronchoalveolar lavage fluid culture confirmed the growth of Absidia. His symptoms were relieved with the use of amphotericin B, and he eventually recovered. We also provide a systematic review of relevant literature to summarize the characteristics of pulmonary mucormycosis in immunocompetent patients. Conclusions Pulmonary mucormycosis has variable clinical presentations and is difficult to identify. Due to its high fatality rate, clinicians should make judgements regarding suspected cases correctly and in a timely manner to avoid misdiagnosis and delayed treatment.

Rhino-orbito-cerebral mucormycosis during the COVID-19 third wave in 2021: an Egyptian preliminary report from a single tertiary hospital

“…A high rate of mortality (up to 50%) was reported in patients infected with Mucorales species of fungus [ 2 ]. Mucormycosis most commonly occurs in patients with underlying weak immunity, although sporadically, immunocompetent personnel may be affected [ 1 , 3 , 4 ]. In the pre-COVID-19 era, hematological disorders especially malignancies were found to be the commonest worldwide diseases associated with mucormycosis infection followed by diabetes mellitus [ 5 – 9 ].…”

Risks of mucormycosis in the current Covid-19 pandemic: a clinical challenge in both immunocompromised and immunocompetent patients

“…A recent study conducted by He et al (2021) described the clinical manifestation of a young adult who is immunocompetent but was still diagnosed with Pulmonary Mucormycosis. In addition, they also presented other case studies of immunocompetent patients who were diagnosed with Pulmonary Mucormycosis [ 51 ]. Of 14 patients who received antifungal drugs, 6 died due to either respiratory failure or liver failure, accounting to a mortality rate of 43% [ 52 , 53 ].…”

“…Thus, clinicians should bear in mind that even immunocompetent people are prone to any type of Mucormycosis infection by reviewing the exposure history. Moreover, clinicians should be cautious with the occurrence of pulmonary embolism in patients with signs of lung infection [ 51 ]. Mucormycosis in immunocompetent individuals can be effectively managed by maintaining good nutrition in diet, good hygiene, thoroughly sterilizing air, water, oxygen supply, equipments used for surgical procedures, educating public about precautions, care and creating awareness about disease and most importantly early diagnosis (without any negligence as in case of healthy individuals) and timely treatment.…”

COVID-19 Associated Rhino-Orbital Mucormycosis Complicated by Gangrenous and Bone Necrosis—A Case Report from Honduras

“…Mucormycosis is a fairly rare but life-threatening invasive fungal infection caused by various genera and species of the order Mucorales, with six families being the most common Mucoraceae affecting immunocompromised patients [ 1 ]. Mucormycosis most commonly occurs in patients with underlying host defense defects and increased serum iron availability, although sporadically, immunocompetent hosts may be affected [ 1 , 2 , 3 ]. Mucormycosis is also an important emerging condition among patients with haematological malignancies, allogeneic stem cell transplantation, and diabetes mellitus [ 4 ].…”