A case of pulmonary mucormycosis that occurred during antileukemic chemotherapy

Abstract

The patient was a 64-year-old male. He visited his local doctor with mild fever and general malaise. His white blood cell count was 82,500/μL, and so he was referred to our hematology department. Acute leukemia was diagnosed upon examination of the bone marrow. Remission induction therapy was administered. Complete remission was achieved but fever, coughing, blood-tinged sputum, and chest pain appeared. CT and radiograph of the chest showed left-sided pneumonia, and pulmonary mycoses was suspected. Sputum culture and bronchoscopy did not facilitate pathogen identification. Antibiotics and antifungals were administered, and the symptoms and inflammation showed improvement. However, further CT of the chest showed a remaining mass with a 4.9-cm cavitation in the left lower lobe. Post-remission therapy was scheduled next but due to the high risk of recurring inflammation, left lower lobectomy was performed. Postoperative pathological examination revealed pulmonary mucormycosis. The postoperative course was uneventful, and the patient was discharged after post-remission therapy. Thereafter, there were two recurrences of acute leukemia, and chemotherapy resulted in complete remission. Now, 4 years and 8 months have passed since surgery, but there has been no relapse of lung mucormycosis.