title: Diagnosis of pulmonary mucormycosis aiding the diagnosis of small cell lung cancer.
abstract: Mucormycosis is a rare complication in immunocompromised patients. Antemortem diagnosis of mucormycosis is difficult and often incorrect. We report a case of pulmonary mucormycosis caused by Cunninghamella bertholletiae in an elderly man with interstitial pneumonia. The diagnosis of mucormycosis was established by bronchoalveolar lavage. A coexisting immune deficiency condition was considered. Lung cancer was suspected because of an elevated progastrin-releasing peptide level and bilateral hilar and mediastinal lymphadenopathy; it was diagnosed after performing endoscopic ultrasound-guided fine-needle aspiration. Treatment by intravenous liposomal amphotericin B was effective, but relapse occurred because of bone marrow suppression caused by chemotherapy for lung cancer. Treatment for mucormycosis was resumed, but the patient died of carcinomatous lymphangiosis. Autopsy confirmed the diagnosis of pulmonary mucormycosis and revealed refractory anaemia with small cell lung cancer. Mucormycosis often occurs in immunocompromised patients, but this case is rare because the mucormycosis was diagnosed before the diagnosis of malignancy. Because prognosis is often poor, the possibility of coexisting malignancies should always be investigated in patients with mucormycosis infections.
authors: Department of Respiratory Medicine, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, 522-8539, Japan.
authors: Yasuki
authors: Y
authors: Uchida
authors: Department of Respiratory Medicine, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, 522-8539, Japan.
authors: Mitsuhiro
authors: M
authors: Tsukino
authors: Department of Respiratory Medicine, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, 522-8539, Japan.
authors: Wataru
authors: W
authors: Shigemori
authors: Department of Respiratory Medicine, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, 522-8539, Japan.
authors: Eiichi
authors: E
authors: Hayashi
authors: Department of Respiratory Medicine, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, 522-8539, Japan.
authors: Isao
authors: I
authors: Watanabe
authors: Department of Pathology, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, 522-8539, Japan.
authors: Takahisa
authors: T
authors: Nakayama
authors: Department of Pathology, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, 522-8539, Japan.
authors: Eiji
authors: E
authors: Yamada
authors: Department of Microbiology, Hikone Municipal Hospital, 1882 Hassaka-cho, Hikone, 522-8539, Japan.
authors: Kunihiro
authors: K
authors: Moro
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D020093:Cunninghamella / Q000302:isolation & purification; D017809:Fatal Outcome; D006801:Humans; D007165:Immunosuppression Therapy; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009091:Mucormycosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D055752:Small Cell Lung Carcinoma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000935:Antifungal Agents; D000970:Antineoplastic Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B