amphotericin-b and Tracheal-Diseases

Tracheobronchial mucormycosis is a rare and invasive pulmonary mucormycosis involving the tracheobronchial tree.. At a 3500-bed tertiary care center.. This was a retroactive study of 12 cases of tracheobronchial mucormycosis diagnosed in our hospital, and 48 cases that were previously reported in the English literature.. Rhizopus was the predominant species of pathogen (66.7%). Primary bronchus was the most frequently involved location (38.2%), and upper lobes (51% of cases) were a predilection. Obstructive necrosis and mucosal necrosis were the most common pathological forms (40% and 34.5%, respectively). Fever (59.3%), cough (59.3%), dyspnea (40.7%) and hemoptysis (30.5%) were the most common symptoms. 51.4% patients had rales, 40% had moist rales and 28.6% had negative physical findings. Ninety-five percent patients had immunosuppressive diseases. Diabetes mellitus (66.7%), diabetes ketoacidosis (21.7%), corticosteroid therapy (20%) and kidney insufficiency (18.3%) were the most common predisposing factors. 13.2% had neutropenia which was mostly among the non-diabetic patients (P = .006). Endobronchial lesion of 23.2% had imaging reports with 33.9% exhibiting single mass. Pathological diagnosis of 76.7% used the transbronchial biopsy. The most frequent antifungal therapies were intravenous amphotericin B (79.7%), surgery (33.3%) and surgery combined with amphotericin B therapy (28.3%). Overall in-hospital mortality was 52.5%, with hemoptysis (P = .017), dyspnea at presentation (P = .022) and angioinvasion (P = .03) as independent risk prognostic factors. In contrast, surgery (P = .003) was an independent protection prognostic factor.. Tracheobronchial mucormycosis is a rare but severe disease with high mortality because of its nonspecific clinical presentations and variable predisposing factors.

Topics: Amphotericin B; Antifungal Agents; Bronchial Diseases; Bronchoscopy; Female; Humans; Lung; Male; Middle Aged; Mucorales; Mucormycosis; Tomography, X-Ray Computed; Tracheal Diseases

Topics: Adult; Amphotericin B; Antifungal Agents; Bronchoscopy; Combined Modality Therapy; Diabetes Mellitus, Type 1; Drainage; Female; Humans; Intraoperative Complications; Mucormycosis; Pneumonia; Pneumothorax; Tracheal Diseases

Mucormycosis is a rare opportunistic infection usually associated with immunosuppression, diabetes mellitus or haematological malignancy. Herein, we report an unusual case of mucormycosis in a 46-yr-old male patient with diabetes presenting with an endotracheal mass obstructing the trachea and cartilage damage. Histological examination of the bronchoscopy biopsy specimens revealed invasive mucormycosis. The patient was treated with intravenous amphotericin B followed by removal of the lesion via bronchoscopy.

Topics: Amphotericin B; Antifungal Agents; Biopsy; Bronchoscopy; Cartilage; Dyspnea; Humans; Male; Middle Aged; Mucormycosis; Necrosis; Radiography; Trachea; Tracheal Diseases

Mucormycosis is an emerging and fatal fungal infection. A high index of suspicion and the knowledge of its potential manifestations are essential for early diagnosis. We describe a patient with acute lymphoblastic leukaemia (L2 subtype) who developed a neck mass following a course of induction chemotherapy. Doppler ultrasonography and angiography of the neck revealed a pseudoaneurysm of the right common carotid artery. The patient then developed haemoptysis. Surgical exploration revealed a necrotic right common carotid artery with anteromedial pseudoaneurysm and adjacent tracheal wall perforation. Local debridement and tracheal repair were performed. Nonseptate hypheal invasion (mucormycosis) was found on the microscopic examination of the excised arterial wall. A subsequent recurrence of pseudoaneurysm was treated with local surgical debridement and intravenous amphotericin B (Fungizone) administration. Although rare, clinicians should be aware of these possible presenting features of mucormycosis as early diagnosis and treatment may potentially improve the survival.

Topics: Adult; Amphotericin B; Aneurysm, False; Antifungal Agents; Carotid Artery, Common; Humans; Male; Mucorales; Mucormycosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Radiography; Tracheal Diseases; Ultrasonography

Pseudomembranous tracheobronchial aspergillosis coincident with systemic pulmonary aspergillosis represents a rare manifestation of fungal infection in immunocompromized hosts. We report on a patient with recurrent Hodgkin's disease, showing this infectious pattern after treatment with corticosteroids within the antineoplastic schedule, whereas neutropenia--the main risk factor for mold infections--had not occurred. An impaired number of helper T lymphocytes was merely detected as an additional, but hypothetical risk factor, when investigating the status of immunosuppression. Treated systemically with amphotericin B, the patient recovered quickly, although reported mortality rates are disastrous. What is crucial for the clinical management is an early diagnosis by bronchoscopy and cultural proof of the pathogen followed by an adequate antifungal treatment.

Topics: Amphotericin B; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Aspergillosis; Bronchoscopy; Female; Hodgkin Disease; Humans; Immunocompromised Host; Lung Diseases, Fungal; Middle Aged; Neutropenia; Opportunistic Infections; Tracheal Diseases

Invasion of the major airways is a rare manifestation of respiratory tract involvement by Aspergillus sp. and is seen almost exclusively in immunocompromised patients. We present calcification as a new feature of this condition and its demonstration by ultrasound in a 15-year-old boy with severe neutropenia secondary to aplastic anaemia.

Topics: Adolescent; Amphotericin B; Anemia, Aplastic; Antifungal Agents; Aspergillosis; Calcinosis; Humans; Immunocompromised Host; Male; Neutropenia; Trachea; Tracheal Diseases; Ultrasonography

Topics: Airway Obstruction; Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Bronchoscopy; Fatal Outcome; Female; Humans; Middle Aged; Respiration, Artificial; Tracheal Diseases

Topics: Amphotericin B; Child; Child, Preschool; Coccidioidomycosis; Granuloma; Humans; Male; Miconazole; Radiography; Tracheal Diseases; Tracheal Stenosis

Mucormycosis (phycomycosis) has been reported to involve most organ systems in man. We report a young insulin-dependent diabetic who presented with acute upper airway obstruction because of isolated mucormycosis of the trachea. A combination of amphotericin B and surgical resection of the lower two thirds of the larynx and five tracheal rings with primary reanastomosis has resulted in a cure with no evidence of recurrence after nine months of follow-up. To our knowledge, this represents the first report of isolated tracheal mucormycosis and/or acute upper airway obstruction due to mucormycosis.

Topics: Adult; Airway Obstruction; Amphotericin B; Diabetes Complications; Female; Humans; Mucormycosis; Tracheal Diseases; Tracheotomy

Topics: Airway Obstruction; Amphotericin B; Child, Preschool; Esophageal Diseases; Fungi; Humans; Laryngeal Diseases; Male; Mycoses; Orbit; Respiratory Insufficiency; Tracheal Diseases; Zygoma

Topics: Adult; Aged; Amphotericin B; Diagnosis, Differential; Female; Histoplasmosis; Humans; Laryngeal Diseases; Male; Middle Aged; Otorhinolaryngologic Diseases; Pharyngeal Diseases; Tracheal Diseases