Tumor shape pulmonary mucormycosis associated with sinonasal aspergillosis in a diabetic patient

Sophie Point; Frédéric Gabriel; Hugues Bégueret; Jacques Jougon; Fanny Lanternier; Frédéric Grenouillet; Manal Abdel Fattah; Emilie Catherinot; Chantal Raherison; Elodie Blanchard

doi:10.1016/j.mmcr.2017.08.001

Tumor shape pulmonary mucormycosis associated with sinonasal aspergillosis in a diabetic patient

Med Mycol Case Rep. 2017 Sep 1:19:13-17. doi: 10.1016/j.mmcr.2017.08.001. eCollection 2018 Mar.

Authors

Affiliations

¹ Pneumology Department, Hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France.
² Parasitology and Mycology Department, Hôpital Pellegrin, CHU de Bordeaux, place Amélie Raba Léon 33000 Bordeaux, France.
³ Pathology Department, Hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France.
⁴ Thoracic Surgery Department, Hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac, France.
⁵ Infectious and Tropical Disease Department, Centre d'infectiologie Necker-Pasteur, 149 rue de Sèvres, 75015 Paris, France.
⁶ Parasitology and Mycology Department, CHRU Besançon, 2 boulevard Fleming, 25030 Besançon cedex, France.
⁷ Infectious and Tropical Disease Department, CHRU Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy, France.
⁸ Pneumology Department, Hôpital Foch, 40 rue Worth, 92150 Suresnes, France.
⁹ INSERM U1219 Université de Bordeaux, 146 rue leo Saignat, 33076 Bordeaux, France.

Abstract

Mucormycosis is a rare and life-threatening fungal infection of the Mucorales order occurring mainly in immunosuppressed patients. The most common forms are rhinocerebral but pulmonary or disseminated forms may occur. We report the case of a 61-year-old patient in whom pulmonary mucormycosis was diagnosed during his first-ever episode of diabetic ketoacidosis. While receiving liposomal amphotericin B, a sinusal aspergillosis due to Aspergillus fumigatus occurred. Evolution was slowly favorable under antifungal tritherapy by liposomal amphotericin B, posaconazole and caspofungin.

Keywords: BAL, Bronchoalveolar Lavage; Bronchial obstruction; Diabetic ketoacidosis; Fungal infection; GVH, raft Versus Host disease; PCR, Polymerase Chain Reaction; Pulmonary mucormycosis; Sinusal aspergillosis.