Mediastinal Mucormycosis: Case report, review of literature and treatment with continuous liposomal amphotericin B irrigation

Mediastinal mucormycosis is an uncommon but lethal infection associated with an 83% mortality. We describe a case of fatal Rhizopus microsporus mediastinitis despite three exploratory mediastinal surgeries and complementary systemic and mediastinal irrigation with liposomal amphotericin B. We further review the literature on surgical and antifungal management of mediastinal mucormycosis.

[1]  P. Bharadwaj,et al.  Sclerosing Mediastinitis Presenting as Complete Heart Block. , 2017, Journal of clinical and diagnostic research : JCDR.

[2]  J. Perfect,et al.  Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis. , 2016, The Lancet. Infectious diseases.

[3]  A. Chakrabarti,et al.  Mediastinitis and Bronchial Perforations Due to Mucormycosis. , 2015, Journal of Bronchology & Interventional Pulmonology.

[4]  P. Vyas,et al.  Mediastinal Zygomycosis (Mucormycosis): an Unusual Manifestation of Invasive Zygomycosis (Mucormycosis), Presenting as a Mediastinal Mass in an Immunocompetent Adult Male , 2014 .

[5]  N. Rajagopalan,et al.  Coinfection of pulmonary mucormycosis and aspergillosis presenting as bilateral vocal cord palsy , 2013, BMJ Case Reports.

[6]  A. Guleri,et al.  Salvage therapy with topical antifungal for Aspergillus fumigatus empyema complicating extrapleural pneumonectomy. , 2012, Interactive cardiovascular and thoracic surgery.

[7]  B. Spellberg,et al.  Pathogenesis of mucormycosis. , 2012, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[8]  A. Attarbaschi,et al.  Mucormycosis in paediatric patients: demographics, risk factors and outcome of 12 contemporary cases , 2011, Mycoses.

[9]  M. Jan,et al.  A rare pulmonary zygomycosis manifested as chronic mediastinitis and bronchial perforation , 2011, European Respiratory Journal.

[10]  J. Meis,et al.  Disseminated Rhizopus microsporus infection in a patient on oral corticosteroid treatment: a case report. , 2009, The Netherlands journal of medicine.

[11]  M. Schuster,et al.  Posaconazole as Salvage Therapy for Zygomycosis , 2006, Antimicrobial Agents and Chemotherapy.

[12]  D. Kontoyiannis,et al.  Epidemiology and outcome of zygomycosis: a review of 929 reported cases. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[13]  B. Robertson,et al.  Fibrosing mediastinitis secondary to zygomycosis in a twenty-two-month-old child. , 2002, The Pediatric infectious disease journal.

[14]  J. Ribes,et al.  Zygomycetes in Human Disease , 2000, Clinical Microbiology Reviews.

[15]  E. Anaissie,et al.  Amphotericin B lipid complex for invasive fungal infections: analysis of safety and efficacy in 556 cases. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  J. Hsu,et al.  A case report of novel roentgenographic finding in pulmonary zygomycosis: thickening of the posterior tracheal band. , 1996, Kaohsiung Journal of Medical Sciences.

[17]  R. K. Marwaha,et al.  Mediastinal zygomycosis. , 1985, Postgraduate medical journal.

[18]  B. A. Connor,et al.  Mucor mediastinitis. , 1979, Chest.

[19]  A. Leong.  Granulomatous mediastinitis due to rhizopus species. , 1978, American journal of clinical pathology.