title: Concurrent pulmonary zygomycosis and Mycobacterium tuberculosis infection: a case report.
abstract: A non-smoking 77-year old gentleman of Indian origin was admitted with a 4-month history of intermittent night sweats, haemoptysis and 6 kg of weight loss. CT scan of thorax demonstrated a 2.5 cm mass in the right middle lobe with multiple small nodules within the right lung and confirmed the presence of mediastinal and hilar lymph nodes.Fibreoptic bronchoscopy demonstrated a distorted right main bronchus, anterior shift of the right upper lobe and occlusion of the right middle lobe bronchus with a black necrotic ulcer. Mycobacterium tuberculosis was found in the bronchoalveolar lavage and histology demonstrated numerous fungal hyphae with a morphological appearance of zygomycetes within necrotic areas of tissue. Medical management with anti-fungal and anti-mycobacterial treatment was instigated as the patient's pre-existing IHD did not permit surgical intervention. Subsequently CT imaging following completion of therapy demonstrated improvement of the mass and a resolution of the associated nodules. The patient has been followed for 6 months to date and there has been no recurrence of symptoms. Recent bronchoalveolar lavage cultures have been negative for M. tuberculosis and zygomycetes.
authors.affiliation: Department of Respiratory Medicine, St James's University Hospital, Leeds, UK. ian.clifton@leedsth.nhs.uk.
authors.forename: Tejal
authors.initials: T
authors.lastname: Patel
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Clifton
authors.forename: Jack A
authors.initials: JA
authors.lastname: Kastelik
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Peckham