Pulmonary Mucormycosis: An Emerging Infection

Muqeetadnan, Mohammed; Rahman, Ambreen; Amer, Syed; Nusrat, Salman; Hassan, Syed Adeel; Hashmi, Syed

doi:10.1155/2012/120809

Cited by 20 publications

(22 citation statements)

References 13 publications

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“…Os sintomas relatados no caso foram também descritos por Muqeetadnan et al 15 em um paciente de 68 anos. Diante dos achados de consolidações no lobo inferior direito, secreção e úlceras na parede brônquica com necrose isquêmica, o paciente foi submetido à pneumonectomia e foram iniciados os antifúngicos anfotericina B e caspofungina.…”

Section: Discussionunclassified

Mucormicose aguda por Rhizopus isolado de fragmento de tecido pulmonar de paciente imunocomprometido: relato de caso / Acute Mucormycosis due to Rhizopus isolated in patient´s lung tissue fragments: case report

Oliveira¹,

Mendes²,

Cambuim³

2017

Rev Cienc Saude

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Palavras-Chave:Mucormicose Cetoacidose Rhizopus Pneumopatias RESUMO O gênero Rhizopus é responsável por várias infecções, dentre elas a pulmonar, a qual acomete até 11% dos casos. O objetivo desse estudo é relatar o isolamento do gênero Rhizopus sp. de fragmento de tecido pulmonar de um paciente com cetoacidose diabéti-ca. Paciente do gênero masculino, 22 anos, queixou-se de dispneia, dor intensa no hemitórax esquerdo e dorso. Foram solicitados: teste rápido para HIV, duas pesquisas para baciloscopia, exame de radiologia do tórax e uma cultura micológica de fragmento de tecido pulmonar. No exame micológico direto, foram observadas várias hifas hialinas largas de paredes finas e cenocíticas, estolões e rizoides, e, em cultura, houve o desenvolvimento de colônia de crescimento rápido em temperatura ambiente, de coloração inicialmente branca. A micromorfologia da cultura revelou a presença de esporangiófo-ros com esporângios contendo esporangiosporos, o que confirma diagnóstico de mucormicose por Rhizopus sp. O paciente foi a óbito devido ao agravamento do quadro clí-nico. Keywords:Mucormycosis Ketoacidosis Rhyzopus Acute lung injury ABSTRACT The Rhyzopus genus is responsible for various infections, including the lung infection, which affects up to 11% of the cases. The aim of this study is to report the isolation of genus Rhyzopus sp. of lung tissue fragment of a patient having diabetic ketoacidosis. Male patient, 22 years of age, complaining of dyspnea, severe pain in the left hemithorax and back. It was requested: a quick test for HIV, two surveys to smear, radiological examination of the chest and a mycological culture of lung tissue fragments. The direct mycological examination revealed several large hyaline hyphae with thin walls and cenocytic walls, stolons and rhizoids. The culture exam has shown the developing of a fast-growing colony at room temperature, initially white. The micromorphology of the culture has shown the presence of sporangiophores with sporangia containing sporangiospores confirming the diagnosis of mucormycosis by Rhyzopus sp. The patient died due to the worsening of clinical condition.CC BY-NC-SA 4.0 2017 RCSFMIt IntroduçãoA mucormicose é uma infecção fúngica rara e grave, descrita pela primeira vez por Paultauf, em 1885, e que surge sobretudo em doentes imunocomprometidos. 1 Os Mucorales, por apresentarem tropismo vascular (aderem ao revestimento das células endoteliais dos vasos), provocam no pulmão invasão vascular com trombose, isquemia, febre, tosse, expectoração amarelada e até mesmo hemoptise. Além disso, ocorrem infartos hemorrágicos, levando a manifestações clínicas, patológicas e radiológicas semelhantes à aspergilose invasiva. 2,3 Doentes com mucormicose pulmonar localizada apresentam elevada taxa de mortalidade (65%-76%); 4,5 em pacientes com a doença disseminada, a mortalidade chega a 96% dos casos. 4 Após a inalação dos esporos presentes no meio ambiente, o fungo atinge preferencialmente os lobos pulmonares superiores e o prognóstico da infecção é reservado. 4 A sepse, a in...

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Section: Discussionunclassified

Mucormicose aguda por Rhizopus isolado de fragmento de tecido pulmonar de paciente imunocomprometido: relato de caso / Acute Mucormycosis due to Rhizopus isolated in patient´s lung tissue fragments: case report

Oliveira¹,

Mendes²,

Cambuim³

2017

Rev Cienc Saude

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“…The symptoms of pulmonary mucormycosis are typically non-specific, even at late stages of infection, and may include fever, dyspnea, coughing and chest pain. Rare cases can present as progressive subcutaneous emphysema, Pancoast syndrome, Horner's syndrome, or chronic mediastinitis and bronchial perforation ( 7 , 14 – 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…Unlike pulmonary aspergillosis, pulmonary mucormycosis has a prognosis and outcome that have not significantly improved over the last decade, mainly due to the difficulty in forming an early diagnosis and the limited activity of current antifungal agents against Mucorales ( 9 , 11 ). Pulmonary mucormycosis is a rapidly fatal illness, with an overall mortality rate of 76%, which increases to 95% with extrathoracic dissemination ( 5 , 7 , 9 , 40 – 43 ). If untreated, survival beyond 2 weeks is distinctly unusual ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary mucormycosis: A case report and review of the literature

et al. 2016

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The current study reports the case of a 15-year-old male who presented to The First Affiliated Hospital of Soochow University (Suzhou, Jiangsu, China) with a 3-day history of anergy and epistaxis. The patient was diagnosed with T-cell acute lymphoblastic leukemia according to the results of a bone marrow examination and received chemotherapy. During the agranulocytosis period, the patient developed pneumonia of the right upper lung (RUL). Once complete remission was achieved, the patient underwent a lobectomy of the RUL, together with amphotericin B therapy, following the confirmation of pulmonary mucormycosis by the histopathological results. The patient experienced 12 months of uneventful follow-up post-surgery.

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“…Pulmonary mucormycosis has a predilection to invade the adjacent organs such as the pericardium, chest wall and mediastinum. Invasion of the large mediastinal vessels can lead to massive haemoptysis, which could occasionally be fatal 11 12…”

Section: Discussionmentioning

confidence: 99%

Coinfection of pulmonary mucormycosis and aspergillosis presenting as bilateral vocal cord palsy

et al. 2013

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Invasive pulmonary coinfection with Mucor and Aspergillus is rare. Bilateral vocal cord paralysis resulting from coinfection with these two fungi to our knowledge has not been reported in the literature. We report a young woman with diabetes who presented with symptoms of community acquired pneumonia in association with hoarseness of voice. Investigations revealed air space consolidation of the right upper lobe, evidence of mediastinal involvement extending into the paratracheal space and entrapment of right upper lobe pulmonary artery. Bronchoscopy revealed bilateral vocal cord paralysis and sloughing of mucosa of the right upper lobe bronchus and the bronchus intermedius. Microbiological and pathological results confirmed Mucor and Aspergillus. Extensive vascular and mediastinal involvement precludes surgical debridement. Despite aggressive medical management the patient deteriorated and died of respiratory failure. Strong suspicion of invasive fungal infections in immune compromised patients presenting with unresolving pneumonia and hoarseness of voice, early aggressive treatment is crucial for the patient survival.

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Pulmonary Mucormycosis: An Emerging Infection

Cited by 20 publications

References 13 publications

Mucormicose aguda por Rhizopus isolado de fragmento de tecido pulmonar de paciente imunocomprometido: relato de caso / Acute Mucormycosis due to Rhizopus isolated in patient´s lung tissue fragments: case report

Mucormicose aguda por Rhizopus isolado de fragmento de tecido pulmonar de paciente imunocomprometido: relato de caso / Acute Mucormycosis due to Rhizopus isolated in patient´s lung tissue fragments: case report

Pulmonary mucormycosis: A case report and review of the literature

Coinfection of pulmonary mucormycosis and aspergillosis presenting as bilateral vocal cord palsy

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