Mucormycosis is a rare but invasive opportunistic fungal infection with increased frequency during chemotherapy-induced neutropenia. The clinical infections due to Mucor include rhinocerebral, pulmonary, cutaneous, gastrointestinal and disseminated diseases. The first two are the most common diseases and all entities are associated with a high mortality rate. Still hepatic involvement of Mucor is rarely reported. We experienced a case of hepatic and small bowel mucormycosis in a 56-year-old woman after induction chemotherapy for B-cell acute lymphocytic leukemia. Initial symptoms were a high fever unresponsive to broad spectrum antibiotics and pain in the left lower abdominal quadrant. It was followed by septic shock, deterioration of icterus and progressively elevated transaminase. An abdominal CT demonstrated multiple hypodense lesions with distinct margins in both lobes of liver and pericolic infiltration at small bowel and ascending colon. Diagnosis was confirmed by biopsy of the liver. The histopathology of the liver showed hyphae with the right-angle branching, typical of mucormycosis. The patient was managed with amphotericin B and operative correction of the perforated part of the small bowel was performed. However, the patient expired due to progressive hepatic failure despite corrective surgery and long-term amphotericin B therapy.
Case Report ; Female ; Human ; Intestinal Diseases/therapy ; Intestinal Diseases/radiography ; Intestinal Diseases/pathology* ; Intestinal Diseases/microbiology ; Intestine, Small/radiography ; Intestine, Small/pathology ; Liver Diseases/therapy ; Liver Diseases/radiography ; Liver Diseases/pathology* ; Liver Diseases/microbiology ; Middle Age ; Mucormycosis/therapy ; Mucormycosis/radiography ; Mucormycosis/pathology* ; Mucormycosis/microbiology ; Tomography Scanners, X-Ray Computed

Pulmonary mucormycosis is a relatively rare but highly virulent and rapidly progressive disease that occurs after inhalation of spores of the fungi that belong to class Zygomycetes. This infection occasionally occurs in seriously immunocompromised patients, but also in patients with uncontrolled diabetes or diabetic ketoacidosis. Diagnosis is pathologic demonstration of typical hyphae within lung tissue, and requires aggressive treatments including surgical and medical approach for reducing the overall mortality. In Korea, pulmonary mucormycosis complicated with diabetes has been reported in only five cases. Recently, we experienced a case of pulmonary mucormycosis in 32-year-old poorly controlled diabetic man, who had nonspecific pulmonary symptoms, a lobar consolidation on chest radiograph, and endobronchial lesions on bronchoscopic finding. We reported here our case and reviewed characteristics of other five previous cases.
Adult ; Diabetes Mellitus* ; Diabetic Ketoacidosis ; Diagnosis ; Fungi ; Humans ; Hyphae ; Immunocompromised Host ; Inhalation ; Korea ; Lung ; Mortality ; Mucormycosis* ; Radiography, Thoracic ; Spores

Diagnostic Errors ; Humans ; Lung Diseases, Fungal ; diagnosis ; drug therapy ; pathology ; Male ; Middle Aged ; Mucormycosis ; diagnosis ; drug therapy ; pathology ; Radiography, Thoracic ; Tomography, X-Ray Computed

Emphysematous pyelonephritis is a rare, life endangering suppurative infection characterized by the production of intrarenal and occasionally perirenal gas which generally occurs in patient with diabetes mellitus or urinary tract obstruction. Clinically, it appears as an acute severe clinical pyelonephritis that needs emergency care with poor prognosis. Recently, we experienced six cases of emphysematous pyelonephritis, so a clinical study was made on these six patients who were admitted to the Department of Urology, Kyung Hee University from April 1986 to June 1987. The results were as followings : 1. Four patients were female and 2 were male, age distribution ranged from 31 to 72 years. All patients had diabetes mellitus and duration of diabetes mellitus ranged from 8 months to 10 years. 2. Causative organism were E. coli in 5 patients, and Mucormycosis in 1 patient who had alcoholism and septic pneumonia. 3. the disease involved right kidney in 3 patients, the left kidney in 3 patients. Bilateral emphysematous pyelonephritis was not found. 4. Simple abdominal radiography and renal sonogram were performed in 6 patients to identify the gas in renal area. Computerized tomography were used to localize the gas and extent of infection, in 4 patients. Intraparenchymal gas only was found in 1 patient, gas in renal parenchyme and perineral space was found in 5 patients. 5 3 patients were treated by conservative management and other 3 patients underwent nephrectomy. 2 patients were expired, one is treated by nephrectomy and another by conservative ma-nagement each other. 4 patients survived.
Age Distribution ; Alcoholism ; Diabetes Mellitus ; Emergency Medical Services ; Female ; Humans ; Kidney ; Male ; Mucormycosis ; Nephrectomy ; Pneumonia ; Prognosis ; Pyelonephritis* ; Radiography, Abdominal ; Urinary Tract ; Urology