Isolated Tracheal Mucormycosis - A Rare Entity
Reshma Ramanan*, Dali Chandran, Rasha Nahan and Honey Ashok
Department of E.N.T, Sakra World Hospital, India
*Corresponding Author: Reshma Ramanan, Senior Resident, Department of E.N.T, Sakra World Hospital, India.
Received:
June 12, 2023; Published: July 10, 2023
Abstract
Mucorymycosis is a fungal infection caused by rapidly invasive filamentous fungi of the Mucorale order. Typically, patients who are immunocompromised or have uncontrolled diabetes fall prey to this uncommon infection. Manifestations of Mucormycosis can range from a pulmonary infection to a lethal rhino-orbital-cerebral infection. The mortality rate of this disease is very high.
The clinical presentation of pulmonary and respiratory tract mucormycosis is non-specific. These include cough, dyspnea, haemoptysis, fever, and therefor can easily be missed if the index of suspicion is kept low. Our case represents one of the various respiratory manifestations of the disease, which usually presents as a pulmonary infection associated with a tracheo-bronchial spread. However an isolated tracheal involvement as seen in our case makes this a rare one.
Here we report a case of isolated tracheal mucormycosis in a previously undetected case of uncontrolled diabetes, successfully treated over a prolonged period. Our discussion spans early diagnosis, treatment, cure and rehabilitation. She was treated over a protracted course of hospital stay and out-patient care, requiring multiple hospital admissions- with both medical and timely surgical intervention being vital in the survival of the patient.
Early detection and aggressive evaluation are vital in making an accurate diagnosis so as not to delay treatment. The three cardinal elements of management of an invasive fungal infection are- control of risk factors, antifungal treatment and early surgical intervention.
Keywords: Laryngotracheal; Mucormycosis; Fungal; Tracheal; Mucor
References
- Manjunath M., et al. “Refractory bronchovascular pleuropulmonary mucormycosis: Case report and difficulties in management”. Lung India: Official Organ of Indian Chest Society1 (2018): 70-72.
- Singh Awadhesh Kumar., et al. “Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India”. Diabetes and Metabolic Syndrome4 (2021): 102146.
- Mishra Yogendra., et al. “Diabetes, COVID 19 and mucormycosis: Clinical spectrum and outcome in a tertiary care medical center in Western India”. Diabetes and Metabolic Syndrome4 (2021): 102196.
- He Ruoxi., et al. “Report of 12 cases with tracheobronchial mucormycosis and a review”. The Clinical Respiratory Journal 4 (2018): 1651-1660.
- Spellberg Brad., et al. “Novel perspectives on mucormycosis: pathophysiology, presentation, and management”. Clinical Microbiology Reviews3 (2005): 556-569.
- Bajwa Awais., et al. “Endobronchial mucormycosis: A rare clinical entity diagnosed by endobronchial cryobiopsy”. Respiratory Medicine Case Reports 37 (2022): 101660.
- Prakash Hariprasath., et al. “A prospective multicenter study on mucormycosis in India: Epidemiology, diagnosis, and treatment”. Medical Mycology4 (2019): 395-402.
- Roden Maureen M., et al. “Epidemiology and outcome of zygomycosis: a review of 929 reported cases”. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America5 (2005): 634-653.
- Jeong Wirawan., et al. “Contemporary management and clinical outcomes of mucormycosis: A systematic review and meta-analysis of case reports”. International Journal of Antimicrobial Agents5 (2019): 589-597.
- Manesh Abi., et al. “Mucormycosis-A clinicoepidemiological review of cases over 10 years”. Mycoses4 (2019): 391-398.
- Chakrabarti Arunaloke., et al. “The rising trend of invasive zygomycosis in patients with uncontrolled diabetes mellitus”. Medical Mycology4 (2006): 335-342.
- Patel Atul K., et al. “Mucormycosis at a tertiary care centre in Gujarat, India”. Mycoses6 (2017): 407-411.
- Cornely Oliver A., et al. “Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium”. The Lancet Infectious Diseases12 (2019): e405-e421.
- Bala Kiran., et al. “A prospective study of mucormycosis in north India: experience from a tertiary care hospital”. Medical Mycology3 (2015): 248-257.
- Afroze Syeda Neelam., et al. “Mucormycosis in a Diabetic Patient: A Case Report with an Insight into Its Pathophysiology”. Contemporary Clinical Dentistry4 (2017): 662-666.
- Danion François., et al. “What Is New in Pulmonary Mucormycosis?”. Journal of Fungi (Basel, Switzerland)3 (2023): 307.
- van Burik, Jo-Anne H., et al. “Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases”. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 7 (2006): e61-65.
- Spellberg Brad., et al. “The Deferasirox-AmBisome Therapy for Mucormycosis (DEFEAT Mucor) study: a randomized, double-blinded, placebo-controlled trial”. The Journal of Antimicrobial Chemotherapy3 (2012): 715-722.
- Fallahi Mohammad Javad., et al. “Near-Complete tracheal obstruction due to mucormycosis: A report of two cases”. Clinical Case Reports8 (2022): e6278.
- Ansari Reza., et al. “Mucormycosis Mimicking Tracheal Tumor: A Case Report”. Iranian Journal of Medical Microbiology2 (2021): 247-256.
- Chaddha Udit., et al. “A 55-Year-Old Man with a Trachea Undressed”. Annals of the American Thoracic Society7 (2017): 1212-1215.
- Munjal Manish., et al. “Laryngeal Mucormycosis: A Rare Entity”. International Journal of Otorhinolaryngology and Head and Neck Surgery1 (2017): 278.
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