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隐匿性窒息者:揭示气管狭窄为毛霉菌病的非典型表现

Silent choker: Unveiling tracheal stenosis as an atypical manifestation of mucormycosis.

作者信息

Kaliya Mehul G, Rathod Mittal C, Deokar Kunal K, Singhal Sanjay

机构信息

Department of General Medicine, AIIMS, Rajkot, Gujarat, India.

Department of Community Medicine, AIIMS, Jammu, Jammu and Kashmir, India.

出版信息

Lung India. 2024 Jan 1;41(1):63-66. doi: 10.4103/lungindia.lungindia_250_23.

Abstract

Airway mucormycosis is a fatal opportunistic infection typically seen in immunocompromised individuals. In this case report, we present an unusual instance of tracheal stenosis in a patient with diabetes mellitus who had recently recovered from coronavirus 2019 (COVID-19). Our patient was a 69-year-old male with poorly controlled type-II diabetes mellitus, on oral hypoglycemic agents, who had successfully completed treatment for COVID-19. Approximately one month later, he developed a cough, fever and breathlessness. Several factors, including advanced age, history of smoking and tobacco chewing, the nodular appearance of the trachea on bronchoscopy, hypermetabolic wall of the trachea on positron emission tomography scan and dysplasia on biopsy, initially raised suspicion of malignancy. However, repeated biopsies from multiple sites confirmed the diagnosis of tracheal mucormycosis. The patient was treated with amphotericin-B and posaconazole. We extensively reviewed the literature and found only 14 reported cases to discuss compared to ours.

摘要

气道毛霉病是一种致命的机会性感染,通常见于免疫功能低下的个体。在本病例报告中,我们介绍了一名糖尿病患者在近期从2019冠状病毒病(COVID-19)康复后出现气管狭窄的不寻常病例。我们的患者是一名69岁男性,患有控制不佳的II型糖尿病,正在服用口服降糖药,他已成功完成COVID-19治疗。大约一个月后,他出现咳嗽、发热和呼吸困难。包括高龄、吸烟和嚼烟史、支气管镜检查时气管的结节状外观、正电子发射断层扫描时气管壁代谢亢进以及活检时的发育异常等多种因素,最初引发了对恶性肿瘤的怀疑。然而,从多个部位反复活检确诊为气管毛霉病。该患者接受了两性霉素B和泊沙康唑治疗。我们广泛查阅了文献,发现与我们的病例相比,仅有14例报告病例可供讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/425c/10883443/7cca0222b420/LI-41-63-g001.jpg

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