Successful treatment of mixed pulmonary Aspergillus and Mucor infection using intrabronchial amphotericin B infusion: a case report and literature review

BMC Pulm Med. 2024 Sep 4;24(1):436. doi: 10.1186/s12890-024-03234-z.

Abstract

Background: Reports of pulmonary aspergillosis and mucormycosis co-infections are rare; thus, limited guidance is available on early diagnosis and treatment. We present a case of mixed pulmonary Aspergillus and Mucor infection and review the literature regarding this co-infection. The diagnosis and treatment methods are summarized to improve clinicians' understanding of the disease and to facilitate early diagnosis and treatment.

Case presentation: A 60-year-old male farmer with poorly controlled diabetes mellitus was admitted to hospital with a fever of unknown origin that had been present for 15 days and pulmonary aspergillosis complicated by Mucor spp.

Infection: Because multiple lobes were involved, the infection worsened despite surgical resection and antifungal therapy. Finally, we treated this patient with a bronchoscopic infusion of amphotericin B. After four courses of bronchoscopic amphotericin B infusion, we observed rapid clinical improvement and subsequent resolution of pulmonary infiltrates.

Conclusion: Our case highlights the use of bronchoscopy in the successful clinical treatment of invasive fungal diseases of the lung.

Keywords: Amphotericin B; Bronchoscopic treatment; Invasive fungal infections; Pulmonary aspergillosis; Pulmonary mucormycosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amphotericin B* / administration & dosage
  • Amphotericin B* / therapeutic use
  • Antifungal Agents* / administration & dosage
  • Antifungal Agents* / therapeutic use
  • Bronchoscopy*
  • Coinfection / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Mucor / isolation & purification
  • Mucormycosis* / diagnosis
  • Mucormycosis* / drug therapy
  • Pulmonary Aspergillosis* / diagnosis
  • Pulmonary Aspergillosis* / drug therapy
  • Tomography, X-Ray Computed

Substances

  • Amphotericin B
  • Antifungal Agents