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Bronchial mucormycosis with progressive air trapping
D M Collins1, T A Dillard, K W Grathwohl
1Department of Medicine, Madigan Army Medical Center, Tacoma, Wash. 98431, USA.
Mayo Clinic Proceedings
|July 16, 1999
Summary
A rare Rhizopus arrhizus fungal infection caused a severe airway ulcer and respiratory failure in an immunocompetent woman. Despite treatment, the patient succumbed to secondary bacterial pneumonia and septic shock.
Area of Science:
- Pulmonology
- Infectious Diseases
- Mycology
Background:
- A previously healthy 70-year-old woman presented with progressive respiratory symptoms including fever, cough, and dyspnea over two months.
- Initial treatments with antibiotics and corticosteroids were ineffective, leading to hospital admission due to hypoxemia and hyperglycemia.
Observation:
- Chest imaging revealed diffuse pulmonary opacities and air trapping.
- Bronchoscopy identified a deep ulcer in the bronchus intermedius with exposed cartilage and dynamic airway obstruction.
Findings:
- Biopsy confirmed the presence of Rhizopus arrhizus, a rare cause of pulmonary fungal infection.
- The patient initially stabilized on mechanical ventilation and amphotericin B.
Implications:
- This case highlights the aggressive nature of Rhizopus arrhizus infections, even in immunocompetent individuals.
- It underscores the importance of considering rare fungal pathogens in refractory respiratory conditions.
- The patient's death from secondary Pseudomonas aeruginosa pneumonia and septic shock emphasizes the critical risk of superimposed infections.