title: Successful Treatment of Invasive Pulmonary Mucormycosis in an Immunocompromised Patient.
abstract: A 59-year-old man undergoing chemotherapy for acute myelogenous leukemia had a bilateral pneumonic process. The right lung subsequently developed several small cavitary lesions extending from the central hilum to the chest wall. Despite medical therapy, repeat imaging demonstrated coalescence into a single, large, central cavitary lesion. Thoracic surgery was consulted because of the central hilar involvement of all three lobes; a pneumonectomy would have been required to resect the lesion. However, he was not a candidate for pneumonectomy because of a low predicted postoperative forced expiratory volume in 1 second. We performed a rib resection, debridement, and marsupialization, in which the skin was sewn circumferentially to the parietal pleura. His wound was managed with wet-to-dry dressings. Postoperatively, he recovered well, with resolution of his cough. Three weeks after surgery, he was discharged from the hospital, and the cavity completely closed at 4 months.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Loma Linda University, Loma Linda, California.
authors.forename: Oluwatobi
authors.initials: O
authors.lastname: Afolayan
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Loma Linda University, Loma Linda, California.
authors.forename: Hannah
authors.initials: H
authors.lastname: Copeland
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Loma Linda University, Loma Linda, California.
authors.forename: Rachel
authors.initials: R
authors.lastname: Hargrove
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Loma Linda University, Loma Linda, California.
authors.forename: Salman
authors.initials: S
authors.lastname: Zaheer
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Loma Linda University, Loma Linda, California. Electronic address: jmwallen@llu.edu.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Wallen
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001706:Biopsy; D018893:Bronchoalveolar Lavage / Q000379:methods*; D001999:Bronchoscopy; D006801:Humans; D016867:Immunocompromised Host; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000175:diagnosis / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D000935:Antifungal Agents