A Case of Disseminated Mucormycosis Involving Lung, Chest Wall and Central Nervous System / 대한내과학회지

ABSTRACT

Disseminated mucormycosis is a rare but fatal fungal infection with a high mortality rate. Mucormycosis usually occurs in immunocompromised patients such as in patients with diabetes mellitus, leukemia, lymphoma and in patients undergoing anticancer therapy, prolonged immunosuppression, and antibiotic therapy. Early diagnosis and the resolution of predisposing factors, including the use of amphotericin B and wide surgical resection, are essential to make a successful outcome. We report a well-documented case of disseminated mucormycosis involving lung parenchyme, chest wall and central nervous system with the review of literatures in patients with uncontrolled diabetes and Evans' syndrome. Typical broad, branching in right angle, non-septated hyphae were observed in the biopsy of the nodular mass on the anterior chest wall. Chest CT and brain MRI found three pulmonary cavitary lesions and multiple small nodules with ring-enhancement in the cerebrum, cerebellum and the brainstem. Although 1,116mg of amphotericin B in sum was given with flucytosine, she expired due to progressive mucormycosis.