Pulmonary Mucormycosis with a Staphylococcus epidermidis Co-infection

Albert Pai; Kalpaj R. Parekh; Evgeny V. Arshava

doi:10.1201/9781315265889-32

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Book chapter

Pulmonary Mucormycosis with a Staphylococcus epidermidis Co-infection

Albert Pai, Kalpaj R. Parekh and Evgeny V. Arshava

Thoracic Surgery, pp.163-167

CRC Press, 1

2020

DOI: 10.1201/9781315265889-32

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Abstract

Mucormycosis is a severe opportunistic fungal infection that requires prompt diagnosis and aggressive surgical treatment. We present the case of a patient with diabetes and chronic lymphocytic leukemia with mucormycosis of the right upper lobe with a Staphylococcus epidermidis co-infection that we have not encountered in the literature. Mucormycosis is commonly associated with an immunosuppressed state, active malignancy, uncontrolled diabetes, and iron-overloaded states. In patients with hematological malignancies, mucormycosis most commonly affects the lungs. Pathology of the specimen demonstrated extensive parenchymal necrosis of the lung with Mucor and co-infecting Staphylococcus epidermidis. Mucormycosis, previously known as zygomycosis, is an opportunistic fungal infection that commonly affects immunosuppressed patients, diabetics, patients with active malignancy, and those with iron-overloaded states. Its involvement in patients without a predisposing factor is rare. Chest X-ray is usually abnormal in most patients, but findings are rarely suggestive of fungal disease. Chest Computed tomography will demonstrate consolidation, nodules, masses, cavitation, lymphadenopathy, or pleural effusions without specific lobar predilection. Oral posaconazole or isavuconazonium are used as step-down antifungals for responders of amphotericin B or for salvage therapy, but either type of medication is ineffective without surgical intervention.

Preoperative CT Scan

Opportunistic Fungal Infection

Percutaneous Needle Biopsy

Core Needle Biopsy

Chest CT

Trachea Esophageal Fistula

Pulmonary Mucormycosis

Ground Glass Opacity

Endoscopic Closure

Gastroesophageal Junction

Focal Infiltrates

Inferior Pulmonary Vein

Oral Posaconazole

Air Crescent Sign

Paraesophageal Hernia

Ampicillin Sulbactam

White Blood Cell

Chest Wall Reconstruction

Internal Elastic Membrane

Iron Overloaded States

Details

Title: Subtitle: Pulmonary Mucormycosis with a Staphylococcus epidermidis Co-infection
Creators: Albert Pai
Kalpaj R. Parekh
Evgeny V. Arshava
Contributors: Wickii T. Vigneswaran (Editor)
Resource Type: Book chapter
Publication Details: Thoracic Surgery, pp.163-167
Edition: 1
Publisher: CRC Press
DOI: 10.1201/9781315265889-32
Alternative title: Pulmonary Mucormycosis with a Staphylococcus epidermidis Co-infection
Language: English
Date published: 2020
Academic Unit: Anatomy and Cell Biology; Cardiothoracic Surgery
Record Identifier: 9984322773002771

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