Tracheal, laryngeal and pulmonary mucormycosis followed by organizing pneumonia in a patient with Adult Onset Still's Disease

Fabian Leo; Michael Zeh; Annegret Prothmann; Oliver Kurzai; Sylke Kurz; Christian Grohé

doi:10.1016/j.mmcr.2018.02.001

Tracheal, laryngeal and pulmonary mucormycosis followed by organizing pneumonia in a patient with Adult Onset Still's Disease

Med Mycol Case Rep. 2018 Feb 6:20:28-32. doi: 10.1016/j.mmcr.2018.02.001. eCollection 2018 Jun.

Authors

Fabian Leo¹, Michael Zeh², Annegret Prothmann³, Oliver Kurzai^{4

5}, Sylke Kurz¹, Christian Grohé¹

Affiliations

¹ Department of Respiratory Medicine, Evangelische Lungenklinik Berlin, Lindenberger Weg 27, 13125 Berlin, Germany.
² Bioptisches Institut, Institute of Pathology, Lindenberger Weg 27, 13125 Berlin, Germany.
³ Department of Radiology, Evangelische Lungenklinik Berlin, Lindenberger Weg 27, 13125 Berlin, Germany.
⁴ German National Reference Center for Invasive Fungal Infections NRZMyk, Leibniz Institute for Natural Product Research and Infection Biology, Adolf-Reichwein-Straße 23, 07745 Jena, Germany.
⁵ Institute for Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Str. 2/E1, 97080 Würzburg, Germany.

Abstract

We report a case of tracheal, laryngeal and pulmonary mucormycosis in a patient receiving immunosuppressive medication for an autoinflammatory fever syndrome. Mucormycosis was confirmed by histopathology from tracheal specimens and molecular evidence of Lichtheimia. A surgical approach was not possible because of the multifocal disease pattern and the extent of tracheal involvement. The patient was successfully treated with liposomal amphotericin B followed by posaconazole maintenance therapy. After 9 months, recurrent pulmonary mucormycosis was suspected but emerged as organizing pneumonia without evidence of active fungal infection.

Keywords: Lichtheimia; Organizing pneumonia; Pulmonary mucormycosis; Tracheal mucormycosis.