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Journal List > Tuberc Respir Dis > v.64(6) > 1001244

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Cho, Kang, Kim, Jeong, Jang, Kim, Hwang, and Lee: A Case of Angio-invasive Pulmonary Mucormycosis with Uncontrolled Diabetes Mellitus
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 64(6): 451-455.

Published online: 30 June 2008

DOI: https://doi.org/10.4046/trd.2008.64.6.451

A Case of Angio-invasive Pulmonary Mucormycosis with Uncontrolled Diabetes Mellitus

Yu Ji Cho, M.D.1, Myoung-Hee Kang, M.D.1, Hyeon Sik Kim, M.D.1, Yi Yeong Jeong, M.D.1, In-Seok Jang, M.D.2, Ho Cheol Kim, M.D.1, Young Sil Hwang, M.D.1, Jong Deog Lee, M.D.1

1Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.

2Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University College of Medicine, Jinju, Korea.

Address for correspondence: Jong Deog Lee, M.D. Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Gyeongsang National University, 92, Chilam-dong, Jinju 660-751, Korea. Phone: 82-55-750-8611, Fax: 82-55-758-9122, ljd8611@empal.com

Received 2 May 2008       Accepted 2 June 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Pulmonary mucormycosis is an uncommon, serious opportunistic infection caused by fungi belonging to the order Mucorales and it occurs exclusively in debilitated or immuno-compromised hosts. It is known that the fungi can invade the blood vessels and cause serious ischemic necrosis and bleeding5. We experienced a fatal case of pulmonary mucormycosis in a diabetic 75-year-old man who developed a progressive necrotizing lesion despite administering proper and prompt medical and surgical treatment. We report here on this case along with a review of the relevant medical literature.

Keywords: Mucormycosis, Angio-invasive, Diabetes-mellitus

Figures and Tables

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Figure 1
Initial chest PA (A) and chest CT (B, C) showed two ground glass opacities with hyperlucent area in left upper lobe and another small ground glass opacity with suspicious air-crescent sign in right upper lobe.

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Figure 2
Bronchoscopic exam showed purulent secretion from upper division of left upper lobe. Bronchial washing and transbronchial lung biopsy was done in upper division of left upper lobe bronchus.

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Figure 3
Microscopic finding shows non-septate broad hyphae of mucorales with infiltration of inflammatory cells in pulmonary parenchyme (Gomori-methanamine silver stain, ×400).

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Figure 4
Serial Chest X-rays showed rapid progressive lesion in both lung field. Compared with chest X-ray at admission (A), follow up X-ray at 15th day showed to progress on both lung fields (B). Large cavitary lesion was seen in right upper lung field. It was only small ground glass opacity at admission. At 35th day, newly developed opacity in right upper lobe and near total haziness in left lung field was noted (C).

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Figure 5
Gross (A) and microscopic finding (B) from surgical specimen. Invasion of mucorales hyphae into pulmonary vascular wall was observed (arrow, H&E stain, ×400).

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References

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