Korean J Med.  2007 May;72(5):551-557.

A case of pulmonary mucormycosis complicated by pneumomediastinum and subcutaneous emphysema after chemotherapy in a patient with small cell lung cancer

• Lee SJ
• Yoon SJ
• Kim EJ
• Cha SI
• Park JY
• Jung TH
• Kim CH

Abstract

Pulmonary mucormycosis is an uncommon fungal opportunistic infection found mainly in immunosuppressed patients or in patients with poorly controlled diabetes mellitus. A case of pulmonary mucormycosis complicated by pneumomediastinum and subcutaneous emphysema in small cell lung cancer has not yet been reported to date. A 61-year-old patient with a small cell lung cancer was in a course of clinical improvement with chemotherapy until the development of new bilateral lung lesions after the fourth round of chemotherapy. After diagnosing mucormycosis by a transbronchial lung biopsy of the new lesions, the condition of the patient improved with amphotericin B treatment, but radiographic cavitations of mucormycosis persisted. After 2.4 months of administering oral itraconazole medication, additional chemotherapy was performed due to cancer progression. Mucormycosis developed complicated by pneumomediastinum and subcutaneous emphysema, which resulted from fistula formation of the cavity lesion of the left side into the mediastinum. The patient died of a fungal sepsis despite a surgical resection of the left lesion.

Keyword

Mucormycosis; Small cell lung cancer; Mediastinal emphysema; Subcutaneous emphysema

MeSH Terms

Amphotericin B
Biopsy
Diabetes Mellitus
Drug Therapy*
Fistula
Humans
Itraconazole
Lung
Mediastinal Emphysema*
Mediastinum
Middle Aged
Mucormycosis*
Opportunistic Infections
Sepsis
Small Cell Lung Carcinoma*
Subcutaneous Emphysema*
Amphotericin B
Itraconazole