A case of pulmonary mucormycosis complicated by pneumomediastinum and subcutaneous emphysema after chemotherapy in a patient with small cell lung cancer / 대한내과학회지

ABSTRACT

Pulmonary mucormycosis is an uncommon fungal opportunistic infection found mainly in immunosuppressed patients or in patients with poorly controlled diabetes mellitus. A case of pulmonary mucormycosis complicated by pneumomediastinum and subcutaneous emphysema in small cell lung cancer has not yet been reported to date. A 61-year-old patient with a small cell lung cancer was in a course of clinical improvement with chemotherapy until the development of new bilateral lung lesions after the fourth round of chemotherapy. After diagnosing mucormycosis by a transbronchial lung biopsy of the new lesions, the condition of the patient improved with amphotericin B treatment, but radiographic cavitations of mucormycosis persisted. After 2.4 months of administering oral itraconazole medication, additional chemotherapy was performed due to cancer progression. Mucormycosis developed complicated by pneumomediastinum and subcutaneous emphysema, which resulted from fistula formation of the cavity lesion of the left side into the mediastinum. The patient died of a fungal sepsis despite a surgical resection of the left lesion.