Yousaf Muhammad, Salameh Sarah, Haq Irfan Ul, Alhyassat Samir, Thomas Merlin, Hussain Aisha, Wani Mohd, Massad Ehab, Hadi Hamad Abdel, Sattar Hisham Abdul, Hameed Mansoor
Hazm Mebaireek Hospital, Hamad Medical Corporation, Doha, Qatar.
Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
Respir Med Case Rep. 2021 Jul 8;33:101474. doi: 10.1016/j.rmcr.2021.101474. eCollection 2021.
Diabetes Mellitus appears to be the most common underlying condition associated with mucormycosis; a rare opportunistic fungal infection associated with high morbidity and mortality. Pulmonary mucormycosis may mimic pneumonia and thus pose challenges in achieving a timely diagnosis critical to successful outcomes. We present a case of a 65-year-old diabetic who presented with fever and haemoptysis that was managed as pneumonia. A bronchial alveolar lavage grew mould that was thought to be a contaminant as he responded well to antibiotics. He required another admission in 4 weeks due to worsening symptoms. Failure to respond to antibiotics and ongoing clinical and radiological deterioration led to a lobectomy that confirmed a diagnosis of pulmonary mucormycosis. He responded well to surgical resection and antifungal therapy with a complete recovery. Elusive clinical presentation and insensitive conventional diagnostic techniques may make the diagnosis of mucormycosis challenging. Our case reports highlight the issues involved in the diagnosis and management of pulmonary Mucormycosis mimicking as pneumonia.
糖尿病似乎是与毛霉菌病相关的最常见基础疾病；毛霉菌病是一种罕见的机会性真菌感染，发病率和死亡率都很高。肺毛霉菌病可能类似肺炎，因此在及时诊断方面存在挑战，而及时诊断对成功治疗至关重要。我们报告一例65岁糖尿病患者，该患者因发热和咯血就诊，最初按肺炎进行治疗。支气管肺泡灌洗培养出霉菌，由于患者对抗生素反应良好，当时认为该霉菌是污染物。4周后，因症状恶化他再次入院。由于对抗生素无反应且临床和影像学表现持续恶化，遂行肺叶切除术，术后确诊为肺毛霉菌病。他对手术切除和抗真菌治疗反应良好，完全康复。毛霉菌病难以捉摸的临床表现和不敏感的传统诊断技术可能使其诊断具有挑战性。我们的病例报告强调了在诊断和治疗疑似肺炎的肺毛霉菌病时所涉及的问题。
