Pulmonary Mucormycosis with an Appearance of Consolidation

경화 양상으로 나타난 폐의 Mucormycosis

  • Kim, Shin-Chae (Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Lee, Heung-Bum (Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Lee, Yong-Chul (Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Rhee, Yang-Keun (Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
  • 김신재 (전북대학교 의과대학 내과학교실) ;
  • 이홍범 (전북대학교 의과대학 내과학교실) ;
  • 이용철 (전북대학교 의과대학 내과학교실) ;
  • 이양근 (전북대학교 의과대학 내과학교실)
  • Published : 2000.07.30

Abstract

The mucormycosis is a group of serious opportunistic infections caused by fungi of the class Zygomycetes and order Mucorales. Pulmonary mucormycosis is a relatively rare disease but typically manifested by a rapidly progressive, often fatal pneumonia in patients with diabetes mellitus, hematologic malignant neoplasms, or organ transplants. The radiologic manifestations of pulmonary mucormycosis are nonspecific and include progressive lobar or multilobar consolidations, pulmonary masses and pulmonary nodules. Recently, we experienced a pulmonary mucormycosis in 32-year-old man with uncontrolled diabetes. He complained of cough, left pleuritic chest pain and generalized weakness. Initial chest X-ray finding was the consolidation on the lower lobe of the left lung. On the sixth hospital day, bronchoscopic examination with lung biopsy revealed broad, non-septate hyphae with right-angle branching, diagnostic of mucormycosis, and consequently amphotericin B therapy was started. We performed a lobectomy of the left lower lobe of the lung on 29th hospital day.

폐모균증은 치명적인 결과를 초래하는 기회감염으로 조기진단 및 치료가 요망된다. 하지만 본 증례와 같이 폐모균증의 방사선학적 소견은 비특이적이므로 조기 진단이 용이하지 않다. 이에 저자들은 폐모균종의 발생 위험인자를 내포한 환자가 항생제에 반응을 보이지 않으면서 방사선 소견상 폐의 경화, 종괴, 결절, 공동 등의 소견을 보이는 경우 폐모균증올 고려함이 필요하다고 생각되어 문헌고찰과 함께 본 증례를 보고하는 바이다.

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