Bansal Meghana, Martin Sara R, Rudnicki Stacy A, Hiatt Kim M, Mireles-Cabodevila Eduardo
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
J Med Case Rep. 2011 Aug 17;5:388. doi: 10.1186/1752-1947-5-388.
Pancoast syndrome is characterized by Horner syndrome, shoulder pain radiating down the arm, compression of the brachial blood vessels, and, in long-standing cases, atrophy of the arm and hand muscles. It is most commonly associated with lung carcinoma but rarely is seen with certain infections.
We present the case of a 51-year-old Caucasian man who had acute myeloid leukemia and who developed a rapidly fulminating pneumonia along with signs and symptoms of acute brachial plexopathy and left Horner syndrome. Also, a purpuric plaque developed over his left chest wall and progressed to skin necrosis. The skin biopsy and bronchoalveolar lavage showed a Rhizopus species, leading to a diagnosis of mucormycosis. This is a rare case of pneumonia due to mucormycosis associated with acute Pancoast syndrome.
According to our review of the literature, only a few infectious agents have been reported to be associated with Pancoast syndrome. We found only three case reports of mucormycosis associated with acute Pancoast syndrome. Clinicians should consider mucormycosis in their differential diagnosis in a patient with pulmonary lesions and chest wall invasion with or without neurological symptoms, especially in the setting of neutropenia or other immunosuppressed conditions. It is important to recognize this condition early in order to target therapy and interventions.
潘科斯特综合征的特征为霍纳综合征、沿手臂放射的肩部疼痛、臂部血管受压，在病程较长的病例中还会出现手臂和手部肌肉萎缩。它最常与肺癌相关，但在某些感染中很少见。
我们报告一例51岁的白种男性病例，该患者患有急性髓系白血病，并发快速进展的暴发性肺炎以及急性臂丛神经病和左侧霍纳综合征的体征和症状。此外，其左侧胸壁出现紫癜性斑块并进展为皮肤坏死。皮肤活检和支气管肺泡灌洗显示为根霉菌种，从而诊断为毛霉菌病。这是一例罕见的由毛霉菌病引起的肺炎合并急性潘科斯特综合征的病例。
根据我们对文献的回顾，仅有少数感染因子被报道与潘科斯特综合征相关。我们仅发现三篇毛霉菌病合并急性潘科斯特综合征的病例报告。临床医生在对有肺部病变和胸壁侵犯且有或无神经症状的患者进行鉴别诊断时应考虑毛霉菌病，尤其是在中性粒细胞减少或其他免疫抑制状态的情况下。早期识别这种疾病对于确定治疗方法和干预措施很重要。
