Invasive Mediastinal Mucormycosis with Pulmonary and Cardiac Involvement in an Adult with Chronic Granulomatous Disease: Case Report and Review of the Literature

  • Ashraf Nadeem Respiratory and Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
  • Ali Wahla Respiratory and Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
  • Ashraf Altarifi Department of Critical Care Medicine at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Keywords

Mucormycosis, chronic granulomatous disease, fungi

Abstract

Mucormycosis is a rare fungal infection that often causes rhinocerebral disease. However, there have been rare cases of mediastinal involvement. These patients remain a therapeutic challenge and mortality in this group is very high. We report a case of mediastinal mucormycosis with invasion of the heart and right lung in a patient with chronic granulomatous disease (CGD) and also review the available literature on mediastinal mucormycosis.

VIEW THE ENTIRE ARTICLE

References

  • Spellberg B, Edwards J, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 2005;18(3):556–569. doi:10.1128/CMR.18.3.556-569.2005
  • Winkelstein JA, Marino MC, Johnston RB, Boyle J, Curnutte J, Gallin JI, et al. Chronic granulomatous disease. Report on a national registry of 368 patients. Medicine (Baltimore) 2000;79(3):155–169. doi:10.1097/00005792-200005000-00003
  • Falcone EL, Holland SM. Invasive fungal infection in chronic granulomatous disease: insights into pathogenesis and management. Curr Opin Infect Dis 2012;25(6):658–669. doi:10.1097/QCO.0b013e328358b0a4
  • Dotis J, Pana ZD, Roilides E. Non-Aspergillus fungal infections in chronic granulomatous disease. Mycoses 2013;56(4):449–462. doi:10.1111/myc.12049
  • Mouy R, Veber F, Blanche S, Donadieu J, Brauner R, Levron JC, et al. Long-term itraconazole prophylaxis against Aspergillus infections in thirty-two patients with chronic granulomatous disease. J Pediatr 1994;125(6 Pt 1):998–1003. doi:10.1016/s0022-3476(05)82023-2
  • Beauté J, Obenga G, Le Mignot L, Mahlaoui N, Bougnoux ME, Mouy R, et al. Epidemiology and outcome of invasive fungal diseases in patients with chronic granulomatous disease: a multicenter study in France. Pediatr Infect Dis J 2011;30(1):57–62. doi:10.1097/INF.0b013e3181f13b23
  • Cooper JD, Gotoff RA, Foltzer MA, Carter RA, Walsh TJ. Mediastinal mucormycosis: case report, review of literature and treatment with continuous liposomal amphotericin B irrigation. Mycoses 2019;62(9):739–745. doi:10.1111/myc.12922
  • Khan S, Waqar Elahi M, Ullah W, Abdullah HMA, Ahmad E, Al Mohajer M, et al. Invasive mucormycosis induced pneumopericardium: a rare cause of pneumopericardium in an immunocompromised patient. Case Rep Infect Dis 2017;2017:1424618. doi:https://doi.org/10.1155/2017/1424618
  • Blanco X, Ramirez D, Brown ARA. Surviving an aggressive pulmonary tumor mimicker - pulmonary and mediastinal mucormycosis. Am J Resp Crit Care Med 2020;201:A1745. https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A1745
  • Seifert S, Wiley J, Kirkham J, Lena S, Schiers K. Pulmonary mucormycosis with extensive bronchial necrosis and bronchomediastinal fistula: a case report and review. Respir Med Case Rep 2020;30:101082. doi:10.1016/j.rmcr.2020.101082
  • Tedder M, Spratt JA, Anstadt MP, Hegde SS, Tedder SD, Lowe JE. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg 1994;57(4):1044–1050. doi:10.1016/0003-4975(94)90243-7
  • Spellberg B, Ibrahim A, Roilides E, Lewis RE, Lortholary O, Petrikkos G, et al. Combination therapy for mucormycosis: why, what, and how? Clin Infect Dis Off Publ Infect Dis Soc Am 2012;54(Suppl 1):S73–S78. doi:10.1093/cid/cir885
  • Published: 2021-05-05

    Issue: 2021: Vol 8 No 5 (view)

    Section: Articles

    How to cite:
    1.
    Nadeem A, Wahla A, Altarifi A. Invasive Mediastinal Mucormycosis with Pulmonary and Cardiac Involvement in an Adult with Chronic Granulomatous Disease: Case Report and Review of the Literature. EJCRIM 2021;8 doi:10.12890/2021_002435.