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( Khai Lip Ng ),( Nai-chien Huan ),( Ummi Nadira Daut ),( Sanusi Zulkifli ),( Noorul Afidza Muhammad ),( Mona Zaria Nasaruddin ),( Jamalul Azizi Abdul Rahaman ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Introduction Pulmonary murcomycosis is an uncommon fungal infection that typically affects immunocompromised patients. Rarely, it can affect immunocompetent patients, presenting as endobronchial lesions mimicking lung malignancy. Herein we report a patient with pulmonary murcomycosis with favourable treatment outcome via a multimodality approach utilizing antifungal agents and endobronchial intervention. Case Report A 31-year-old lady with no prior medical condition presented with a 3-month history of cough associated with weight loss of more than 5 kilograms and occasional haemoptysis (blood streaks in sputum). Chest radiograph and computed tomography demonstrated mediastinal lymphadenopathy and left hilar mass with infiltration into left main bronchus. Flexible bronchoscopy revealed presence of an endobronchial mass occluding the left main bronchus. Her tuberculosis workup, diabetes screening and retroviral tests were all negative but she was found to be pregnant at 6weeks. She was subsequently scheduled for rigid bronchoscopy and debulking of endobronchial mass. To our surprise, histopathological examination revealed inflamed tissue with presence of fungal organism which was subsequently confirmed to be Rhizopus microspores via fungal polymerase-chain-reaction. With the diagnosis in mind, she was promptly treated with intravenous amphotericin-B for a total of 2 weeks in duration, which was accompanied by clinical improvements and total radiological resolution. Amphotericin-B was chosen instead of other anti-fungal agents after taking into account of her pregnancy status. Conclusion Murcomycosis should be considered among young patients who presented with endobronchial lesion. Rapidly progressing nature of the disease warrants early diagnosis and treatment to ensure a better clinical outcome.
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