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Angioinvasive pulmonary mucormycosis presenting with massive haemoptysis secondary to pulmonary artery pseudoaneurysm
Sourabh Prakash Kulkarni1, Venkatraman Bhat2, Gadabanahalli Karthik1
1Radiology, Narayana Health city, Bengaluru, Karnataka, India.
Abstract:
Pulmonary artery pseudoaneurysm (PAP) is a rare but potentially fatal entity caused by a variety of underlying conditions. They may be congenital in origin or occur due to infective complications or occasionally secondary to pulmonary arterial hypertension. Among infective processes, tuberculosis and bacterial infections are the most common causative agents. There are few isolated reports of angio-invasive mucormycosis causing PAP; many of them were detected postmortem. Diagnosis of specific aetiology is often overlooked due to lack of clinical suspicion, as a result of incomplete investigations or due to inappropriate imaging. This report presents a case of pulmonary mucormycosis complicated by PAP in a patient with clinically unsuspected, uncontrolled diabetes. We highlight how the combination of heightened clinical suspicion, appropriate imaging and timely intervention helped us to treat a potentially fatal complication in our patient.
Insights
Pulmonary artery pseudoaneurysm (PAP) is a rare complication of infections like mucormycosis, especially in uncontrolled diabetes. Early diagnosis and intervention are crucial for treating this potentially fatal condition.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- Pulmonary artery pseudoaneurysm (PAP) is a rare, potentially fatal condition.
- PAP can arise from congenital issues, infections (tuberculosis, bacterial), or pulmonary hypertension.
- Angio-invasive mucormycosis is an uncommon cause of PAP, often diagnosed postmortem.
Purpose of the Study:
- To present a case of pulmonary mucormycosis complicated by PAP.
- To emphasize the importance of clinical suspicion and diagnostic imaging in identifying the specific etiology of PAP.
- To highlight successful treatment through timely intervention.
Main Methods:
- Case report presentation.
- Review of clinical presentation, diagnostic imaging (e.g., CT angiography), and treatment course.
- Emphasis on the role of uncontrolled diabetes as a predisposing factor.
Main Results:
- A patient with clinically unsuspected, uncontrolled diabetes developed pulmonary mucormycosis with a complicating PAP.
- Diagnosis was achieved through a combination of clinical suspicion and appropriate imaging.
- Timely intervention led to successful management of the life-threatening complication.
Conclusions:
- Pulmonary mucormycosis can lead to PAP, particularly in patients with uncontrolled diabetes.
- Heightened clinical suspicion and appropriate imaging are vital for diagnosing PAP's specific etiology.
- Prompt diagnosis and intervention are key to managing this severe complication.
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