Fatal pulmonary mycosis in a diabetic and cirrhotic patient

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Ayadi-Kaddour Aïda
Braham Emna
Marghli Adel
Ismail Olfa
Helal Imen
Mlika Mona
Kilani Tarak
El Mezni Faouzi

Abstract

Pulmonary mucormycosis is a rare, devastating, opportunistic fungal infection, caused by the ubiquitous filamentous fungi of the Mucorales order of the class of Zygomycetes. This infection occurs principally in some particular conditions, specially in diabetic patients and immunocompromised host, and rarely in cirrhotic patients. The diagnosis of mucormycosis can only be confirmed by pathological and mycological examination of biopsy specimens. We report a case of pulmonary mucormycosis in a 68-year-old woman with underlying liver cirrhosis and diabetes mellitus. Endoscopic and radiologic findings supported the diagnosis of hydatid cyst of the lung. The patient underwent surgical resection and was started on amphotericin B, after pathological examination. Unfortunately, she succumbed to the infection within one month of surgery.

Keywords:

Mucormycosis - lung - diabetes mellitus - liver cirrhosis - Surgery

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References

  1. Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis 2012 ; 54 : S23 - 34
  2. Herbrecht R, Chabasse D. Zygomycoses : généralités et mucormycoses. Encycl Med Chir (Elsevier, Paris), Maladies infectieuses 1999; 8-614-B- 10
  3. Hamilos G, Samonis G, Kontoyiannis DP. Pulmonary mucormycosis. Semin Respir Crit Care Med 2011 ; 32 : 693 - 702
  4. Loubière R. Mucormycose rhino-orbito-cérébrale due à Rhizopus Oryzae. Un cas typique survenu chez une patiente cirrhotique. Ann Pathol 1993 ; 13 : 180 - 3
  5. Chadli-Chaieb M, Bchir A, Fathallah-Mili A, Ach K, Maaroufi A, Garrouche A, et al. La mucormycose chez le diabétique. Presse Med 2005; 34 : 218 - 22
  6. Vincent L, Biron F, Jardin P, Piens MA, Dannaoui E, Isaac S, et al. Pulmonary mucormycosis in a diabetic patient. Ann Med Interne 2000 ; 151 : 669 - 72
  7. Martinez-Marcos FJ, Viciana P, Canas P, Martin-Juan J, Moreno I, Pachon J. Etiology of solitary pulmonary nodules in patients with human immunodeficiency virus infection. Clin Infect Dis 1997; 24 : 908 - 13
  8. Lin SY, Lu PL, Tsai KB, Lin CY, Lin WR, Chen TC, et al. A mucormycosis case in a cirrhotic patient successfully treated with posaconazole and review of published lietrature. Mycopathologica 2012; 174 : 499-504
  9. Elsiesy H, Saad M, Shorman M, Amr S, Abaalkhail F, Hashim A, et al. Invasive mucormycosis in a patient with liver cirrhosis: case report and review of the literature. Hepatmon 2013; 13 : e10858
  10. Tojima H, Tokudome T, Otsuka T. Chronic pulmonary mucormycosis that developed in preexisting cavities caused by tuberculosis in a patient with diabetes mellitus and liver cirrhosis. Nihon Kyobu Shikkan Gakka Zasshi. 1997; 35 :100-5
  11. Spellberg B, Kontoyiannis DP, Fredricks D, Morris MI, Perfect JR, ChinHong PV, et al. Risk factors for mortality in patients with mucormycosis. Med Mycol 2012; 50 : 611 - 8
  12. Smith JA, Kauffman CA. Pulmonary fungal infections. Respirology 2012 ; 17 : 913 - 26
  13. Tedde M, Spratt JA, Anstadt MP, Hedge SS, Tedder SD, Lowe JE. Pulmonary mucormycosis : results of medical and surgical therapy. Ann Thorac Surg 1994; 57 : 1044 - 50
  14. Serio B, Rosamilio R, Giudice V, Zeppa P, Esposito S, Fontana R, et al. Successful management of pulmonary mucormycosis with liposomal amphotericin B and surgery treatment : a case report. Infez Med 2012; 20 S2 : 43-7
  15. Furco A, Marchet B, Carbonnelle M, Vallerand H. Mucormycose pulmonaire : intérêt des aérosols d'amphotéricine B ? Rev Mal Resp 2001; 18 : 309 - 13
  16. Mendoza-Ayala R, Tapia R, Salathe M. Spontaneously resolving pulmonary mucormycosis. Clin Infect Dis 1999; 29 : 1335 - 6