Revue des maladies respiratoires
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Review Case Reports
[Pulmonary mucormycosis in a leukemia patient. Diagnostic and therapeutic difficulties].
The observation of pulmonary mucormycosis occurring in a patient presenting with aplasia induced therapeutically during treatment for acute myeloblastic leukaemia, has led to a review of the characteristics of this rare opportunistic fungal infection: it occurs in a particular condition; the clinical manifestations are characterised by the thrombotic character and the rapidly necrosing nature of the histological lesions; the diagnosis is usually very difficult to make and is linked to the rarity of the pathology and the frequently negative mycological specimens apart from tissue biopsies; the value of a medicosurgical therapeutic strategy on which the prognosis of the infection depends.
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We report a case of 33 year old man who consulted us in 1994 for recurrent bronchitis sometimes with haemoptysis. The physical examination was unremarkable. At consultation abnormal fascicular sounds were noted at the left base. ⋯ Scintigraphy with ventilation perfusion supplies the essentials to understanding the mechanism (a syndrome of aerated lung which is neither directly ventilated nor perfused). The expiratory function tests most often show a restrictive syndrome but sometimes an obstructive syndrome is found with associated air trapping. The disorder does not progress and the prognosis is good.