Pulmonary Mucormycosis

Overview & Causes

Pulmonary Mucormycosis (PM) is a form of mucormycosis, and a rare form of pneumomycosis (a pulmonary fungal disease). It is very difficult to diagnose and lacks effective treatment. Unlike other fungal infections, like aspergillosis, PM cannot be detected by blood tests due to a lack of circulating antigens.

PM is caused by fungi from the genus Mucor. This fungi is commonly present in decaying matter (such as compost, or spoiled food – bread, fruits, vegetables, etc.). The fungi are conditional pathogens, and rarely cause complications in healthy individuals, but they can cause complications in individuals with compromised immunity.

Infections occur via inhalation of fungal spores, and it spreads via the blood or lymphatic system.

It is hypothesized that there is an increased incidence of PM which is due to the use of antibiotics and immunosuppression.

Patients that are affected by pulmonary mucormycosis are typically immunocompromised, have had organ transplantation, and/or typically suffer from either hematological malignancies, diabetes, or chronic renal failure.

PM accounts for 25% of the cases of mucormycosis.

Symptoms

  • Persistent high fever (>38°C)
  • Cough
  • Hemoptysis (coughing up of blood, or blood-stained mucus)
  • Chest pain
  • Shortness of breath

Clinical Presentation

PM presents itself in the clinic as non-specificity pneumonia.

Diagnosis

CT and MRI are common tests that your doctor or health care provider will perform to help pinpoint the issue and eliminate other conditions. However, the official diagnosis is performed via a mucus culture (via bronchoscopy), which is needed to determine the presence of fungal spores

Treatments

Treatments involved either surgery and/or antifungal medication.

Amphotericin B, a polyene antifungal drug, is the most common antifungal drug used to treat PM. It is typically needed in high doses, because the presence/absorption of the drug in the lungs is lower than in other tissues. Unfortunately, mucormycosis can cause angiemphraxis, which may prevent the drug from reaching the affected site.

Outlook | Prognosis

PM can be severe and fatal. The prognosis typically depends on the stage of infection and when it is detected and diagnosed. If caught early enough, treatment results in complete resolution of the condition.

When To Contact A Medical Professional

Individuals who are immunocompromised and begin to exhibit any of the symptoms mentioned above should seek immediate medical attention.

References