title: Pulmonary Mucormycosis in a Patient with Systemic Lupus Erythematosus: A Diagnostic and Treatment Challenge.
abstract: Pulmonary mucormycosis is commonly encountered in patients with diabetic ketoacidosis, hematologic malignancies, neutropenia, organ or hematopoietic stem cell transplantation, and malignancy, but it rarely occurs in high-risk patients with systemic lupus erythematosus (SLE). We present the case of a 40-year-old SLE female with fulminant pneumonia after remission of nephritis treated with rituximab, who developed severe pulmonary mucormycosis that led to her rapid death from acute respiratory failure and acute respiratory distress syndrome. Pulmonary mucormycosis has a high mortality rate. However, with early diagnosis and antifungal therapy with lipid formulation-liposomal amphotericin B and surgical removal of the infected area, the outcome can be improved.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Nantou Hospital, Ministry of Health and Welfare, No. 478, Fuxing Road, Nantou City, Nantou County 540, Taiwan.
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Hung
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chiu General Hospital, No. 137, Chenggong First Road, Lingya District, Kaohsiung 802, Taiwan.
authors.forename: Gang-Yu
authors.initials: GY
authors.lastname: Shen
authors.affiliation: Department of Family and Community Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; Institute of Medicine and School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan.
authors.forename: Shiuan-Chih
authors.initials: SC
authors.lastname: Chen
authors.affiliation: School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; Division of Allergy, Immunology, Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan.
authors.forename: Kai-Jieh
authors.initials: KJ
authors.lastname: Yeo
authors.affiliation: School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; Institute of Medicine and School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; Division of Infectious Diseases, Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan.
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Tsao
authors.affiliation: Department of Family and Community Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; Institute of Medicine and School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, Sanmin Road, Taichung 403, Taiwan.
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lee
authors.affiliation: School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; Institute of Medicine and School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan ; Division of Infectious Diseases, Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan.
authors.forename: Yuan-Ti
authors.initials: YT
authors.lastname: Lee