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Houston SA, Gu Y, Vandemoortele T, Dumoulin E, Gillson AME, Tyan CC, Sakr L, Bendiak GN, Gonzalez AV, Fortin M. Bronchoscopy during the COVID-19 pandemic: A Canadian Thoracic Society Position Statement update. CANADIAN JOURNAL OF RESPIRATORY, CRITICAL CARE, AND SLEEP MEDICINE 2022. [DOI: 10.1080/24745332.2022.2137317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Simon A. Houston
- Division of Respirology, QEII-Halifax Infirmary, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yusing Gu
- Division of Respirology, QEII-Halifax Infirmary, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Thomas Vandemoortele
- Division of Respiratory Medicine, Department of Medicine, University of Montreal, Montreal, Québec, Canada
| | - Elaine Dumoulin
- Division of Respiratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ashley-Mae E. Gillson
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Chung-Chun Tyan
- Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Lama Sakr
- Division of Respirology, Jewish General Hospital, Department of Medicine, McGill University, Montreal, Québec, Canada
| | - Glenda N. Bendiak
- Section of Respiratory Medicine, Alberta Children’s Hospital, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Anne V. Gonzalez
- Division of Respiratory Medicine, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
| | - Marc Fortin
- Division of Respirology, Institut universitaire de cardiologie et de pneumologie de Québec, Department of Medicine, Université Laval, Québec, Québec, Canada
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Damaraju V, Agarwal R, Dhooria S, Sehgal IS, Prasad KT, Gupta K, Prabhakar N, Aggarwal AN, Muthu V. Isolated tracheobronchial mucormycosis: report of a case and systematic review of literature. Mycoses 2022; 66:5-12. [PMID: 35984683 DOI: 10.1111/myc.13519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/27/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Isolated tracheobronchial mucormycosis (ITBM) is an uncommonly reported entity. Herein, we report a case of ITBM following coronavirus disease 2019 (COVID-19) and perform a systematic review of the literature. CASE DESCRIPTION AND SYSTEMATIC REVIEW A 45-year-old gentleman with poorly controlled diabetes mellitus presented with cough, streaky hemoptysis, and hoarseness of voice two weeks after mild COVID-19 illness. Computed tomography and flexible bronchoscopy suggested the presence of a tracheal mass, which was spontaneously expectorated. Histopathological examination of the mass confirmed invasive ITBM. The patient had complete clinical and radiological resolution with glycemic control, posaconazole, and inhaled amphotericin B (eight weeks). Our systematic review of the literature identified 25 additional cases of isolated airway invasive mucormycosis. The median age of the 26 subjects (58.3% men) was 46 years. Diabetes mellitus (79.2%) was the most common risk factor. Uncommon conditions such as anastomosis site mucormycosis (in 2 lung transplant recipients), post-viral illness (post-COVID-19 [n=3], and influenza [n=1]), and post-intubation mucormycosis (n=1) were noted in a few. Three patients died before treatment initiation. Systemic antifungals were used in most patients (commonly amphotericin B). Inhalation (5/26; 19.2%) or bronchoscopic instillation (1/26; 3.8%) of amphotericin B and surgery (6/26; 23.1%) were performed in some patients. The case-fatality rate was 50%, primarily attributed to massive hemoptysis. CONCLUSION Isolated tracheobronchial mucormycosis is a rare disease. Bronchoscopy helps in early diagnosis. Management with antifungals and control of risk factors is required since surgery may not be feasible.
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Affiliation(s)
- Vikram Damaraju
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Inderpaul Singh Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kuruswamy Thurai Prasad
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kirti Gupta
- Department of Histopathology, * Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nidhi Prabhakar
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashutosh N Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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