title: An autopsy case of pulmonary fissure induced by zygomycosis.
abstract: For immunodeficient patients, fungi are life-threatening pathogens. In this paper, we present an autopsy case of combined zygomycosis and aspergillosis. A female in her 70s on chronic hemodialysis was admitted to a hospital suffering bloody sputum, dyspnea, and fever, probably due to perinuclear anti-neutrophil cytoplasmic antibody-related vasculitis. Antibiotics were administered and immunosuppressive therapy was started, resulting in an improvement in her condition. Pneumonia later developed, followed by pulmonary bleeding and intractable pneumothorax from which she ultimately died. On autopsy, the upper lobe of the left lung was found to have hemorrhagic necrosis and showed a large longitudinal fissure. Microscopically, Zygomycota were observed in both the lungs and heart, while Aspergillus was found in the middle lobe of the right lung. Zygomycosis, which usually has a poor prognosis, is assumed to have induced hemorrhagic infarction of the lungs, inducing pulmonary bleeding and necrosis, despite the use of lipid formulations of amphotericin B, which are effective medicines against Zygomycota.
authors.affiliation: Department of Pediatrics, Kansai Medical University, Osaka.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Imai
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Adachi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kimura
authors.forename: Chikara
authors.initials: C
authors.lastname: Nakano
authors.forename: Toshiki
authors.initials: T
authors.lastname: Shimizu
authors.forename: Ming
authors.initials: M
authors.lastname: Shi
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Okigaki
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Shimo
authors.forename: Kazunari
authors.initials: K
authors.lastname: Kaneko
authors.forename: Susumu
authors.initials: S
authors.lastname: Ikehara
keywords: aspergillosis; immunosuppression; lung; pulmonary fissure; zygomycosis