1887

Abstract

Mucormycosis is a rare complication in immunocompromised patients. Antemortem diagnosis of mucormycosis is difficult and often incorrect. We report a case of pulmonary mucormycosis caused by in an elderly man with interstitial pneumonia. The diagnosis of mucormycosis was established by bronchoalveolar lavage. A coexisting immune deficiency condition was considered. Lung cancer was suspected because of an elevated progastrin-releasing peptide level and bilateral hilar and mediastinal lymphadenopathy; it was diagnosed after performing endoscopic ultrasound-guided fine-needle aspiration. Treatment by intravenous liposomal amphotericin B was effective, but relapse occurred because of bone marrow suppression caused by chemotherapy for lung cancer. Treatment for mucormycosis was resumed, but the patient died of carcinomatous lymphangiosis. Autopsy confirmed the diagnosis of pulmonary mucormycosis and revealed refractory anaemia with small cell lung cancer. Mucormycosis often occurs in immunocompromised patients, but this case is rare because the mucormycosis was diagnosed before the diagnosis of malignancy. Because prognosis is often poor, the possibility of coexisting malignancies should always be investigated in patients with mucormycosis infections.

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2012-11-01
2020-01-28
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References

  1. Baradkar V. P. , Mathur M. , Taklikar S. , Rathi M. , Kumar S. . ( 2008; ). Fatal rhino-orbito-cerebral infection caused by Saksenaea vasiformis in an immunocompetent individual: first case report from India. . Indian J Med Microbiol 26:, 385–387. [CrossRef] [PubMed]
    [Google Scholar]
  2. Gomes M. Z. R. , Lewis R. E. , Kontoyiannis D. P. . ( 2011; ). Mucormycosis caused by unusual mucormycetes, non-Rhizopus, -Mucor, and -Lichtheimia species. . Clin Microbiol Rev 24:, 411–445. [CrossRef] [PubMed]
    [Google Scholar]
  3. Hammond S. P. , Baden L. R. , Marty F. M. . ( 2011; ). Mortality in hematologic malignancy and hematopoietic stem cell transplant patients with mucormycosis, 2001 to 2009. . Antimicrob Agents Chemother 55:, 5018–5021. [CrossRef] [PubMed]
    [Google Scholar]
  4. Jayasuriya N. S. S. , Tilakaratne W. M. , Amaratunga E. A. P. D. , Ekanayake M. K. B. . ( 2006; ). An unusual presentation of rhinofacial zygomycosis due to Cunninghamella sp. in an immunocompetent patient: a case report and literature review. . Oral Dis 12:, 67–69. [CrossRef] [PubMed]
    [Google Scholar]
  5. Kontoyiannis D. P. , Lewis R. E. . ( 2011; ). How I treat mucormycosis. . Blood 118:, 1216–1224. [CrossRef] [PubMed]
    [Google Scholar]
  6. Kontoyiannis D. P. , Wessel V. C. , Bodey G. P. , Rolston K. V. I. . ( 2000; ). Zygomycosis in the 1990s in a tertiary-care cancer center. . Clin Infect Dis 30:, 851–856. [CrossRef] [PubMed]
    [Google Scholar]
  7. Lechevalier P. , Hermoso D. G. , Carol A. , Bonacorsi S. , Ferkdadji L. , Fitoussi F. , Lortholary O. , Bourrillon A. , Faye A. . & other authors ( 2008; ). Molecular diagnosis of Saksenaea vasiformis cutaneous infection after scorpion sting in an immunocompetent adolescent. . J Clin Microbiol 46:, 3169–3172. [CrossRef] [PubMed]
    [Google Scholar]
  8. Mori T. , Egashira M. , Kawamata N. , Oshimi K. , Nakamura K. , Oguri T. , Aida H. , Hiruma A. , Ichinohe M. . ( 2003; ). Zygomycosis: two case reports and review of reported cases in the literature in Japan. . Nippon Ishinkin Gakkai Zasshi 44:, 163–179. [CrossRef]
    [Google Scholar]
  9. Pagano L. , Valentini C. G. , Posteraro B. , Girmenia C. , Ossi C. , Pan A. , Candoni A. , Nosari A. , Riva M. . & other authors ( 2009; ). Zygomycosis in Italy: a survey of FIMUA-ECMM (Federazione Italiana di Micopatologia Umana ed Animale and European Confederation of Medical Mycology). . J Chemother 21:, 322–329.[PubMed] [CrossRef]
    [Google Scholar]
  10. Radner A. B. , Witt M. D. , Edwards J. E. Jr . ( 1995; ). Acute invasive rhinocerebral zygomycosis in an otherwise healthy patient: case report and review. . Clin Infect Dis 20:, 163–166. [CrossRef] [PubMed]
    [Google Scholar]
  11. Roden M. M. , Zaoutis T. E. , Buchanan W. L. , Knudsen T. A. , Sarkisova T. A. , Schaufele R. L. , Sein M. , Sein T. , Chiou C. C. . & other authors ( 2005; ). Epidemiology and outcome of zygomycosis: a review of 929 reported cases. . Clin Infect Dis 41:, 634–653. [CrossRef] [PubMed]
    [Google Scholar]
  12. Schuster M. G. , Stern J. . ( 1995; ). Zygomycosis orbital apex syndrome in association with a solitary lung carcinoma. . J Med Vet Mycol 33:, 73–75. [CrossRef] [PubMed]
    [Google Scholar]
  13. Shiva Prasad B. N. , Shenoy A. , Nataraj K. S. . ( 2008; ). Primary gastrointestinal mucormycosis in an immunocompetent person. . J Postgrad Med 54:, 211–213. [CrossRef] [PubMed]
    [Google Scholar]
  14. Spellberg B. , Edwards J. Jr , Ibrahim A. . ( 2005; ). Novel perspectives on mucormycosis: pathophysiology, presentation, and management. . Clin Microbiol Rev 18:, 556–569. [CrossRef] [PubMed]
    [Google Scholar]
  15. Spellberg B. , Walsh T. J. , Kontoyiannis D. P. , Edwards J. Jr , Ibrahim A. S. . ( 2009; ). Recent advances in the management of mucormycosis: from bench to bedside. . Clin Infect Dis 48:, 1743–1751. [CrossRef] [PubMed]
    [Google Scholar]
  16. Sridhara S. R. , Paragache G. , Panda N. K. , Chakrabarti A. . ( 2005; ). Mucormycosis in immunocompetent individuals: an increasing trend. . J Otolaryngol 34:, 402–406. [CrossRef] [PubMed]
    [Google Scholar]
  17. Sun H. Y. , Singh N. . ( 2011; ). Mucormycosis: its contemporary face and management strategies. . Lancet Infect Dis 11:, 301–311. [CrossRef] [PubMed]
    [Google Scholar]
  18. Tehmeena W. , Hussain W. , Zargar H. R. , Sheikh A. R. , Iqbal S. . ( 2007; ). Primary cutaneous mucormycosis in an immunocompetent host. . Mycopathologia 164:, 197–199. [CrossRef] [PubMed]
    [Google Scholar]
  19. Tominaga M. , Komiya K. , Okamoto S. , Umeguchi H. , Matsuo A. , Iwanaga K. . ( 2010; ). [A case of mucormycosis of the thoracic wall in a non-immunocompromised man]. . Nihon Kokyuki Gakkai Zasshi 48:, 454–457.[PubMed]
    [Google Scholar]
  20. Zeilender S. , Drenning D. , Glauser F. L. , Bechard D. . ( 1990; ). Fatal Cunninghamella bertholletiae infection in an immunocompetent patient. . Chest 97:, 1482–1483. [CrossRef] [PubMed]
    [Google Scholar]
  21. Zhao Y. , Zhang Q. , Li L. , Zhu J. , Kang K. , Chen L. . ( 2009; ). Primary cutaneous mucormycosis caused by Rhizomucor variabilis in an immunocompetent patient. . Mycopathologia 168:, 243–247. [CrossRef] [PubMed]
    [Google Scholar]
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