2017 Volume 31 Issue 7 Pages 938-943
We report a case of pulmonary mucormycosis treated with segmentectomy of the right lung. A 78-year-old man developed a fever and was referred to our hospital. The laboratory data showed pancytopenia, and the patient was diagnosed with acute myeloid leukemia. He started receiving chemotherapy; however, he later developed febrile neutropenia and an abnormal shadow appeared in his right lung. Meropenem and micafungin injections did not yield a response. Consequently, the patient was diagnosed with pulmonary mucormycosis and started receiving amphotericin B. However, the shadow continued to worsen, and surgery was considered as a salvage treatment strategy. The shadow was located in segments 2, 6, and 8, with a smaller shadow in segment 4. We performed right S2+S6+S8a segmentectomy and a wedge resection of segment 4. The patient's postoperative course was uneventful. The chest drainage tube was removed on postoperative day 5, and the patient was discharged on postoperative day 17. Six months later, the patient experienced a recurrence of acute myeloid leukemia, and died 11 months after the operation. He had been receiving additional chemotherapy up until his death; however, he did not show recurrence of the pulmonary mucormycosis. When dealing with pulmonary infectious disease, care must be taken to ensure that the dead space after the operation is as small as possible. Lung segmentectomy is an appropriate option in these cases.
