Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature
Abstract Background Bronchopleural fistula (BFF) is a fistulous communication between the trachea or bronchus and the pleural space. Central type of bronchopleural fistula is usually post-surgical. Infective cause for central bronchopleural fistula is rare. This case report encompasses an infective...
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doaj-427253bfcaf3447f8e6e2c5c1157f8ce2021-07-11T11:33:00ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622021-07-015211510.1186/s43055-021-00546-6Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literatureElamparidhi Padmanaban0Preethi Kannan1Umamageswari Amirthalingam2Sudhakar Pitchumani3Padma Rekha4Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and HospitalDepartment of Radiodiagnosis, Sri Manakula Vinayagar Medical College and HospitalDepartment of Radiodiagnosis, Sri Manakula Vinayagar Medical College and HospitalDepartment of Radiodiagnosis, Sri Manakula Vinayagar Medical College and HospitalDepartment of Radiodiagnosis, Sri Manakula Vinayagar Medical College and HospitalAbstract Background Bronchopleural fistula (BFF) is a fistulous communication between the trachea or bronchus and the pleural space. Central type of bronchopleural fistula is usually post-surgical. Infective cause for central bronchopleural fistula is rare. This case report encompasses an infective cause of central bronchopleural fistula, mucormycosis. Pulmonary mucormycosis is a rapidly progressive condition with high mortality. A high index of suspicion and timely intervention is required to alleviate fatal outcome. The present case is discussed in detail about the clinical presentation and diagnostic imaging of pulmonary mucormycosis presenting with central bronchopleural fistula. Case presentation Thirty-five years old diabetic male, presented with fever, productive cough, mild haemoptysis and chest pain for 10 days duration. The patient was pale on general examination and had decreased breath sound in the right suprascapular and interscapular areas with coarse crackles in the right infrascapular and infra-axillary areas. The laboratory investigations were unremarkable except for anaemia and raised blood glucose level. Sputum examination on potassium hydroxide (KOH) mount showed broad aseptate hyphae. There was a loculated right hydropneumothorax with collapsed lung in chest radiograph. Multi-detector computed tomography of the thorax revealed central type of bronchopleural fistula with the right main bronchus, consolidation of the middle lobe and superior segment of the right lower lobe with multiple internal thick-walled cavities. Right pneumonectomy was performed as the patient did not improve on medical management and showed worsening of symptoms. Histopathological examination was suggestive of mucormycosis. Conclusion Central bronchopleural fistula due to an infective aetiology is uncommon. However, mucormycosis should be considered as a differential diagnosis in cases of central bronchopleural fistula with the destroyed lung, especially in diabetic individuals. Hence, a high index of suspicion is necessary for early diagnosis and management as mucormycosis is a rapidly progressive disease with delay in treatment leading to high mortality.https://doi.org/10.1186/s43055-021-00546-6Pulmonary mucormycosisBronchopleural fistulaEndobronchial |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elamparidhi Padmanaban Preethi Kannan Umamageswari Amirthalingam Sudhakar Pitchumani Padma Rekha |
spellingShingle |
Elamparidhi Padmanaban Preethi Kannan Umamageswari Amirthalingam Sudhakar Pitchumani Padma Rekha Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature The Egyptian Journal of Radiology and Nuclear Medicine Pulmonary mucormycosis Bronchopleural fistula Endobronchial |
author_facet |
Elamparidhi Padmanaban Preethi Kannan Umamageswari Amirthalingam Sudhakar Pitchumani Padma Rekha |
author_sort |
Elamparidhi Padmanaban |
title |
Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature |
title_short |
Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature |
title_full |
Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature |
title_fullStr |
Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature |
title_full_unstemmed |
Pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature |
title_sort |
pulmonary mucormycosis presenting as central bronchopleural fistula—a case report with review of literature |
publisher |
SpringerOpen |
series |
The Egyptian Journal of Radiology and Nuclear Medicine |
issn |
2090-4762 |
publishDate |
2021-07-01 |
description |
Abstract Background Bronchopleural fistula (BFF) is a fistulous communication between the trachea or bronchus and the pleural space. Central type of bronchopleural fistula is usually post-surgical. Infective cause for central bronchopleural fistula is rare. This case report encompasses an infective cause of central bronchopleural fistula, mucormycosis. Pulmonary mucormycosis is a rapidly progressive condition with high mortality. A high index of suspicion and timely intervention is required to alleviate fatal outcome. The present case is discussed in detail about the clinical presentation and diagnostic imaging of pulmonary mucormycosis presenting with central bronchopleural fistula. Case presentation Thirty-five years old diabetic male, presented with fever, productive cough, mild haemoptysis and chest pain for 10 days duration. The patient was pale on general examination and had decreased breath sound in the right suprascapular and interscapular areas with coarse crackles in the right infrascapular and infra-axillary areas. The laboratory investigations were unremarkable except for anaemia and raised blood glucose level. Sputum examination on potassium hydroxide (KOH) mount showed broad aseptate hyphae. There was a loculated right hydropneumothorax with collapsed lung in chest radiograph. Multi-detector computed tomography of the thorax revealed central type of bronchopleural fistula with the right main bronchus, consolidation of the middle lobe and superior segment of the right lower lobe with multiple internal thick-walled cavities. Right pneumonectomy was performed as the patient did not improve on medical management and showed worsening of symptoms. Histopathological examination was suggestive of mucormycosis. Conclusion Central bronchopleural fistula due to an infective aetiology is uncommon. However, mucormycosis should be considered as a differential diagnosis in cases of central bronchopleural fistula with the destroyed lung, especially in diabetic individuals. Hence, a high index of suspicion is necessary for early diagnosis and management as mucormycosis is a rapidly progressive disease with delay in treatment leading to high mortality. |
topic |
Pulmonary mucormycosis Bronchopleural fistula Endobronchial |
url |
https://doi.org/10.1186/s43055-021-00546-6 |
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