Pulmonary Mucormycosis in a Diabetic Patient: Case Report and Literature Review

肺白黴菌病－病例報告

趙文震(Wen-Cheng Chao) ； 陳炯睿(Chiung-Zuei Chen)黃純真(Shun-Chen Huang) ； 黃瑞明(Ruay-Ming Huang)

《胸腔醫學》 25卷2期 (2010/04) Pp. 91-97

https://doi.org/10.29806/TM.201004.0007

摘要

肺白黴菌病是相當少見但可能致命的黴菌感染，通常侵犯免疫功能不全以及糖尿病患者。我們報告一位63歲血糖控制不良的糖尿病患者，因慢性咳嗽、咳血及體重減輕入院，胸部X光及電腦斷層檢查發現左上肺有開洞性病灶，入院後安排氣管鏡檢查並於左側主支氣管發現有一塊大小約0.4×0.4×2.5 cm的長條型組織，我們將該組織塊整個取出並送病理檢查及安排特殊染色，組織學及特殊染色皆符合典型白黴菌病感染表徵，在確診為肺白黴菌之後，我們原先安排左上肺葉切除，但在該組織塊取出之後及良好的血糖控制下，患者臨床症狀及胸部X光追蹤皆大幅改善，因此在和患者討論過後決定暫緩開刀並持續追蹤其後續變化。

關鍵字

白黴菌 ； 糖尿病

並列摘要

Mucormycosis is a rare but potentially lethal fungal infection caused by Zygomycetes, from the order of Mucorales. It commonly affects immunocompromised patients and those with diabetes mellitus. We reported a 63-year-old woman with poorly-controlled type 2 diabetes mellitus who presented with cough, hemoptysis and body weight loss of 10 kgs, from an original weight of 60 kgs, within 6 months. Chest X-ray and computed tomography both showed a cavitary lesion in the left upper lung field with an air-fluid level and obstructive pneumonitis. A large tissue clump, 0.4×0.4×2.5 cm in size, was aspirated out from the left main bronchus during the bronchoscopic examination, and bronchial biopsy showed extensive tissue necrosis and fungal hyphae characteristic of mucormycosis. After the tissue clump had been removed and there was good blood glucose control, both her clinical symptoms and serial image studies showed rapid improvement. We also reviewed the related literature concerning the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of mucormycosis.

並列關鍵字

mucormycosis ； diabetes mellitus