[Combination drug therapy with individualized bronchoscopic intervention for pulmonary mucormycosis]

This article reported a 46-year-old male patient with pulmonary mucormycosis and a history of poorly controlled diabetes. Chest imaging revealed rapidly progressive patchy opacities and multiple cavities in both lungs. Bronchoscopy showed mucor plug obstructing multiple segmental and subsegmental bronchi. The patient underwent sequential treatment, including local nebulization, oral/intravenous antifungals, and bronchoscopic removal of mucor plugs combined with intrabronchial instillation of amphotericin B deoxycholate. However, this yielded no significant improvement. During the procedure, massive airway hemorrhage occurred and was successfully controlled with balloon tamponade. Subsequent exploration with a thin bronchoscope enabled the removal of mucor plugs from subsegmental and distal bronchi. The infusion protocol was adjusted based on chest CT findings by increasing the dosage, volume, and frequency of antimucormycosis drug administration. Following this individualized approach, the patient's condition improved, and he was eventually discharged. This case exemplified the successful combination of pharmacologic and individualized bronchoscopic interventions for pulmonary mucormycosis. It introduced innovations that went beyond current guideline recommendations, highlighting the importance of personalized treatment strategies.