Pulmonary mucormycosis: a surgical monocenter experience

Résumé fourni par la source

Mucormycosis is an opportunistic, severe and uncommon fungal disease, characterized by invasive necrotic lesions. The pulmonary involvement is a rare manifestation that predominantly affects severely immunocompromised patients. methods: It’s a retrospective analysis on patients who underwent surgical management for pulmonary mucormycosis between 2014 and 2024. Results: Four cases of pulmonary mucormycosis were identified (3W/1M) with a mean age of 47 years. The symoptomatology was mild-to-moderate hemoptysis in two cases and dry cough with fever in the remaining two. Radiological findings were nonspecific. Thoracic scans revealed significant parenchymal destruction, with extensive involvement of an entire lung in one case. The diagnosis was confirmed through histopathological and microbiological examination of CT-guided percutaneous biopsies, demonstrating broad, non-septate, ribbon-like fungal filaments. All patients received systemic antifungal therapy with amphotericin B, followed by surgical intervention. A posterolateral thoracotomy was performed in all cases, leading to lobectomy in three patients and pneumonectomy in one case. Postoperative outcomes were uneventful in two cases. One patient presented a prolonged air leakage and another case presented an ischemic stroke resolved without residual sequelae. The mean duration of chest drainage was five days, and the average postoperative hospital stay was 12 days. No perioperative mortality was reported. Conclusion: The management of pulmonary mucormycosis is primarily based on systemic antifungal therapy. Surgical resection remains a last-resort intervention, indicated in cases of disease progression or failure to respond to medical treatment.

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