Chronic pulmonary mucormycosis that developed in preexisting cavities caused by tuberculosis in a patient with diabetes mellitus and liver cirrhosis

Abstract

We describe a case of chronic pulmonary mucormycosis. The patient was a 44-year-old man with diabetes mellitus and alcoholic liver cirrhosis. He had been treated for pulmonary tuberculosis three years earlier and thin-walled cavities remained in the left upper lobe. He presented with coughing, sputum, and fever, and a chest radiograph and CT scan showed increased consolidation around the preexisting cavities in the left lung, along with a small round opacity in the right upper lobe. Transbronchial lung biopsy of the left upper lobe revealed pulmonary mucormycosis with necrosis. Treatment with amphotericin B for two months was not completely successful, particularly with regard to the lesion on the left, so surgery was done. A left upper lobectomy and a left S6 segmentectomy were successful, and the lesion in the right lung resolved after chemotherapy. Pathological examination showed that the resected lung had granulomas, infiltration of inflammatory cells, areas of necrosis, and a druse of Mucor in an abscess. We view this as a case of chronic necrotizing pulmonary mucormycosis.