Use of bronchoscopy-guided treatment and oral posaconazole to treat pulmonary mucormycosis:a case report and literature review  

作　　者：Peng-Cheng Zhou Wei Yu 

机构地区：[1]Department of Respiratory Medicine,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan province,China [2]Clinical Medical School,Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan province,China

出　　处：《Infectious Diseases Research》2021年第4期1-5,共5页传染病研究（英文）

基　　金：funded by the 2020 Xinglin Scholars Scientific Research Promotion Plan of Chengdu University of Traditional Chinese Medicine(QNXZ2020007);the Hundred Talents Plan Project of Hospital of Chengdu University of Traditional Chinese Medicine(20-Q07).

摘　　要：Background:Pulmonary mucormycosis(PM)is rare condition,which is difficult to diagnose and has a high mortality rate.Currently,there is a lack of effective drugs,with few side effects,to treat PM.There have been a few reports on the use of bronchoscopy and posaconazole for the treatment of adult PM.Methods:A man with diabetes mellitus developed diabetic ketoacidosis and subsequently developed repeated cough,hemoptysis,and fever.He was diagnosed with pneumonia and was treated with antibiotics in a local hospital.However,his condition worsened.After admission to our hospital,chest computed tomography(CT)showed bilateral pneumonia and cavities in the left upper lobe that were significantly worse than those seen previously.Bronchoscopy revealed swelling of the left bronchial mucosa and yellow necrosis adhering to the wall.Histology of transbronchial lung biopsy specimens revealed PM pneumonia,characterized by numerous mucormycelia,spores,and neutrophils between necrotic debris.Results:Following diagnosis,liposomal amphotericin B was administered intravenously,and although the symptoms improved significantly,side effects caused the patient to discontinue taking the drug.An alternative regimen,including oral posaconazole and local injection of amphotericin B was administered via bronchoscopy.Finally,the patient did not experience any discomfort and chest CT showed complete resolution of the consolidation and the lung cavity.Conclusion:Bronchoscopy can play an important role in the diagnosis and treatment of PM.The combination of oral posaconazole and bronchoscopy-guided anti-infective therapy is a novel and effective way to treat PM for patient cannot tolerate liposomal amphotericin B.

关 键 词：Pulmonary mucormycosis BRONCHOSCOPY POSACONAZOLE liposomal amphotericin B 

分 类 号：R97[医药卫生—药品]