• Resp Care · Jul 2012

    Case Reports

    Pulmonary zygomycosis in a non-neutropenic patient with myelodysplastic syndrome on lenalidomide.

    • Jesse Theisen-Toupal, Elana S Rosenthal, Emer Kelly, Jeffrey I Zwicker, Praveen Akuthota, and David H Roberts.
    • Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. jtoupal@bidmc.harvard.edu
    • Resp Care. 2012 Jul 1;57(7):1175-7.

    AbstractPulmonary zygomycosis is an uncommon infection that occurs mostly in immunocompromised patients. We report the case of a 75-year-old man with myelodysplastic syndrome, treated with lenalidomide for 3 months, who developed respiratory failure and a rapidly progressive left upper lobe consolidation. An extensive workup was unrevealing of the etiology, and the patient expired. A full autopsy was declined, but an in situ post-mortem transbronchial lung biopsy revealed pulmonary zygomycosis. This unique case illustrates the potential risks of lenalidomide therapy in patients with myelodysplastic syndrome and the difficulties in diagnosing pulmonary zygomycosis. To our knowledge this is the first report of a diagnostic in situ post-mortem transbronchial lung biopsy.

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