A case of resection of pulmonary mucormycosis with repeated lung hemorrhage

Abstract

The patient was a 64-year-old woman with a history of diabetes. She developed bloody sputum and lung hemorrhage in June 2002 and was examined at our hospital. Thoracic computed tomography (CT) revealed a faint ground-glass opacity centered in the left upper lobe. Bronchoarteriography showed that the left bronchial artery was dilated in two places, and embolization was performed. Bloody sputum subsequently decreased, and the lung shadow also disappeared, but a small nodular shadow, 8 mm×5 mm in size, remained in the left upper lobe. The patient remained under observation, and in January 2003, lung hemorrhage reappeared, at which point left lobe resection was performed under video-assisted thoracoscopic surgery. Histological findings were bronchitis with granulation and partly pervaded by mucor fungus, leading to a diagnosis of pulmonary mucormycosis. Six years and two months after surgery, the patient has suffered no recurrence and is attending the diabetes clinic as an outpatient.
Mucormycosis is a rare disorder with a poor prognosis that most often occurs in patients with depressed immune function. In the case described here, the patient suffered from diabetes, and the mucormycosis could be described as secondary, but saprophytic factors in the small nodular shadow in the left upper lobe in which the mucor fungus adhered and proliferated may also have been involved.