year 15, Issue 2 (March - April 2021)                   Iran J Med Microbiol 2021, 15(2): 247-256 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ansari R, Dabirmoghaddam P, Lotfi M, Gheitani M, Sohrabpour S, Heidari F. Mucormycosis mimicking Tracheal Tumor: a case report. Iran J Med Microbiol. 2021; 15 (2) :247-256
URL: http://ijmm.ir/article-1-1163-en.html
1- Department of Otorhinolaryngology and Head & Neck Surgery, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Pathology, Amir-alam Hospital, Tehran University of Medical Sciences, Tehran,Iran
3- Department of Internal Medicine, Shahid-beheshti Hospital, Qom University of MedicalSciences, Qom, Iran
4- Department of Otorhinolaryngology and Head & Neck Surgery, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran. , farrokh.heidari@yahoo.com
Abstract:   (1459 Views)

A 49-year-old woman with a history of diabetes mellitus (DM), and hypothyroidism referred to the emergency ward complaining of shortness of breath which had lasted for three weeks. Due to inspiratory and expiratory stridor in the clinical examination, a tracheal lesion was proposed for her. In computed tomography (CT) scan (without contrast) of the neck and chest, a lesion resembling a malignant tracheal tumor was observed spreading around the cervical trachea. Subsequently, the patient's respiratory distress worsened and she underwent tracheostomy under general anesthesia. During tracheostomy, a white to creamy lesion that resembled necrosis with extensive granulation was seen in cervical trachea, and a biopsy was taken. Histopathological reports showed evidence of acute and chronic inflammation, in necrotic background, along with aseptate fungi which confirmed mucormycosis. Initially, intravenous liposomal amphotericin-B was selected as an antifungal drug which was discontinued due to drug-induced acute renal failure. Posaconazole suspension was replaced as an antifungal drug. After about six weeks, the patient was discharged from the hospital in good general condition. Contrary to few previous studies on mucormycosis of the trachea and lower airways, tracheal disease was limited in our patient; therefore, we avoided debridement of the conflict site and tried to control the disease by controlling the underlying disease (DM), and antifungal therapy. Finally, the desired result was achieved. It should be noted that all patients who have been reviewed in the previous published studies have had a wider conflict sites compared to our patient. Therefore, due to the lack of standard treatment for this disease, our therapeutic approach in this study can be considered as an option in limited and localized cases.

Full-Text [PDF 1701 kb]   (704 Downloads) |   |   Full-Text (HTML)  (675 Views)  
Type of Study: Case report Article | Subject: Medical Mycology
Received: 2020/06/11 | Accepted: 2021/01/3 | ePublished: 2021/04/9

References
1. Skiada A, Pagano L, Groll A, Zimmerli S, Dupont B, Lagrou K, et al. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbiol Infect. 2011;17(12):1859-67. [DOI:10.1111/j.1469-0691.2010.03456.x] [PMID]
2. Luo LC, Cheng DY, Zhu H, Shu X, Chen WB. Inflammatory pseudotumoural endotracheal mucormycosis with cartilage damage. European respiratory review : an official journal of the European Respiratory Society. 2009;18:186-9. [DOI:10.1183/09059180.00000709] [PMID]
3. Mattioni J, Portnoy J, Moore J, Carlson D, Sataloff R. Laryngotracheal mucormycosis: Report of a case. Ear, nose, & throat journal. 2016;95:29-39.
4. Cornely OA, Arikan-Akdagli S, Dannaoui E, Groll AH, Lagrou K, Chakrabarti A, et al. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2013. Clin Microbiol Infect. 2014;20 Suppl 3:5-26. [DOI:10.1111/1469-0691.12371] [PMID]
5. Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J, Jr., Ibrahim AS. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis. 2009;48(12):1743-51. [DOI:10.1086/599105] [PMID] [PMCID]
6. Brown RB, Johnson JH, Kessinger JM, Sealy WC. Bronchovascular mucormycosis in the diabetic: an urgent surgical problem. Ann Thorac Surg. 1992;53(5):854-5. [DOI:10.1016/0003-4975(92)91450-N]
7. Hashemzadeh S, Tubbs RS, Fakhree MBA, Shoja MM. Mucormycotic pseudoaneurysm of the common carotid artery with tracheal involvement. Mycoses. 2008;51(4):347-51. [DOI:10.1111/j.1439-0507.2007.01487.x] [PMID]
8. Mohindra S, Gupta B, Gupta K, Bal A. Tracheal Mucormycosis Pneumonia: A Rare Clinical Presentation. Respiratory Care. 2014;59:e178 - e81. [DOI:10.4187/respcare.03174] [PMID]
9. He R, Hu C, Tang Y, Yang H, Cao L, Niu R. Report of 12 cases with tracheobronchial mucormycosis and a review. Clin Respir J. 2018;12(4):1651-60. [DOI:10.1111/crj.12724] [PMID]
10. Wolf O, Gil Z, Leider-Trejo L, Khafif A, Biderman P, Fliss DM. Tracheal mucormycosis presented as an intraluminal soft tissue mass. Head & Neck. 2004;26(6):541-3. [DOI:10.1002/hed.20055] [PMID]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2022 CC BY-NC 4.0 | Iranian Journal of Medical Microbiology

Designed & Developed by : Yektaweb | Publisher: Farname Inc