Pulmonary mucormycosis-a case series

Abstract

Pulmonary mucormycosis (PM) is a rare disease. Literature about the surgical management of PM in India is sparse. Recently, there has been a surge in the number of cases of mucormycosis in association with the coronavirus disease 2019 (COVID-19) pandemic, igniting the interest in PM. Hence, we endeavoured to analyse our surgical experience in treating PM prior to the pandemic, in a tertiary care centre, to provide insight into this disease. Data of 10 adult patients with isolated PM, who underwent surgery between the years 2009 and 2020, and maintained in our departmental database, were retrieved and analysed.

Keywords: Corticosteroid; Diabetes Mellitus; Lobectomy; Mucormycosis; Pulmonary; Surgery.

Fig. 1

a CT of a patient with PM showing atoll sign (arrow). b Chest radiograph of the same patient showing right lower lobe lesion with air-fluid level (arrow). c Fungal ball with air crescent sign (arrow) mimicking an aspergilloma. d Cavitatory lesion (arrow) mimicking a malignancy. CT, computed tomography; PM, pulmonary mucormycosis

Fig. 2

a Direct microscopy from tissue with calcoflour white fluorescence stain showing broad aseptate hyphae (40 ×). b Lactophenol cotton blue preparation showing Rhizopus sporangiophore (black arrow), rhizoids (red star), sporangium and spores (red arrows) (40 ×). c Photomicrograph displaying broad aseptate fungal hyphae (star) in the wall of a necrotic vessel, periodic acid-Schiff (PAS) (40 ×). d Photomicrograph displaying broad aseptate fungal hyphae (star) in the wall of a necrotic vessel, Gomori methenamine silver (GMS) (40 ×)

Fig. 3

a CT of a renal allograft recipient showing extensive bilateral mucormycosis. b CT of the same patient showing a now resectable lesion localised to right lower lobe (arrow) after 2 months of antifungal therapy. CT, computed tomography