title: Post-bronchoscopy fatal endobronchial hemorrhage in a woman with bronchopulmonary mucormycosis: a case report.
abstract: BACKGROUND
  During infection, Mucorales fungi invade major blood vessels, leading to extensive necrosis, and in cases of extensive pulmonary disease, bleeding into the lungs may occur.
  
  
  METHODS
  We report an unexpected event of post-bronchoscopy fatal endobronchial hemorrhage in a 62-year-old HIV-negative Italian woman with well controlled diabetes mellitus who presented with diffuse cavitated pulmonary lesions. Fiberoptic bronchoscopy revealed bilateral obstruction of the segmental bronchi. Fatal massive bleeding occurred after standard biopsy procedures. Histologic examination showed that the hyphae were more deeply colored by hematoxylin-eosin (H&E) than by other stains for fungi. Culture and autopsy confirmed bronchopulmonary mucormycosis.
  
  
  CONCLUSIONS
  Infection by Mucorales fungi should be considered in the diabetes population regardless of the degree of metabolic control. In these patients, particular caution should be taken during bronchoscopic procedures because of the greater friability of the fungal lesions.
authors.affiliation: Infectious Diseases Section, Department of Health Promotion Sciences, University of Palermo, Palermo, Italy. pdicarlo@unipa.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Di Carlo
authors.forename: Daniela
authors.initials: D
authors.lastname: Cabibi
authors.forename: Anton Maria
authors.initials: AM
authors.lastname: La Rocca
authors.forename: Dario
authors.initials: D
authors.lastname: De Luca
authors.forename: Francesco
authors.initials: F
authors.lastname: La Licata
authors.forename: Ennio
authors.initials: E
authors.lastname: Sacco