Airway necrosis and granulation tissue formation caused by Rhizopus oryzae leading to severe upper airway obstruction: a case report

Front Cell Infect Microbiol. 2024 Mar 4:14:1366472. doi: 10.3389/fcimb.2024.1366472. eCollection 2024.

Abstract

Pulmonary Mucormycosis is a fatal infectious disease with high mortality rate. The occurrence of Mucormycosis is commonly related to the fungal virulence and the host's immunological defenses against pathogens. Mucormycosis infection and granulation tissue formation occurred in the upper airway was rarely reported. This patient was a 60-year-old male with diabetes mellitus, who was admitted to hospital due to progressive cough, sputum and dyspnea. High-resolution computed tomography (HRCT) and bronchoscopy revealed extensive tracheal mucosal necrosis, granulation tissue proliferation, and severe airway stenosis. The mucosal necrotic tissue was induced by the infection of Rhizopus Oryzae, confirmed by metagenomic next-generation sequencing (mNGS) in tissue biopsy. This patient was treated with the placement of a covered stent and local instillation of amphotericin B via bronchoscope. The tracheal mucosal necrosis was markedly alleviated, the symptoms of cough, shortness of breath, as well as exercise tolerance were significantly improved. The placement of airway stent and transbronchial microtube drip of amphotericin B could conduce to rapidly relieve the severe airway obstruction due to Mucormycosis infection.

Keywords: Rhizopus oryzae; amphotericin B; bronchoscopy; mucosal necrosis; tracheal stenosis.

Publication types

  • Case Reports

MeSH terms

  • Airway Obstruction* / etiology
  • Airway Obstruction* / pathology
  • Amphotericin B / therapeutic use
  • Cough / pathology
  • Granulation Tissue / pathology
  • Humans
  • Male
  • Middle Aged
  • Mucormycosis* / diagnosis
  • Mucormycosis* / microbiology
  • Mucormycosis* / pathology
  • Necrosis / pathology
  • Rhizopus oryzae

Substances

  • Amphotericin B

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Z-QS declared that he had received the Youth Fund of Sate Key Laboratory of Respiratory Disease (SKLRD-Z-202314).