Pulmonary multinodular mucormycosis in type 1 diabetic patient with diabetic ketoacidosis

J Endocrinol Invest. 2007 Mar;30(3):247-52. doi: 10.1007/BF03347433.

Abstract

We report a case of pulmonary multinodular mucormycosis in a Type 1 diabetic patient with diabetic ketoacidosis. He had a history of 20-pack-year tobacco use. The initial chest roentgenogram and thorax tomography (after the treatment of diabetic ketoacidosis) revealed multiple nodular lesions with cavitation in the upper lobes of pulmonary parenchyma. Resection of three nodular lesion demonstrated cheesy necrotic mass in the cavitating lesions. The diagnosis of pulmonary multinodular mucormycosis was made depending on the histopathologic examination yielding nonseptated right angle branching-shaped hyphae typical of mucormycosis. The patient was started on liposomal amphotericin B and discharged at the sixth week of therapy with a scheduled therapy of amphotericin B. When he came back after 33 months, he was metabolically unregulated under the insulin therapy. He confessed that he had been smoking heroin besides tobacco for the last 5 years. A new thorax computerized tomography showed that pulmonary nodules were slightly regressed but not resolved.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / diagnostic imaging*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetic Ketoacidosis / complications
  • Diabetic Ketoacidosis / diagnostic imaging*
  • Diabetic Ketoacidosis / drug therapy
  • Heroin Dependence / complications
  • Heroin Dependence / diagnostic imaging
  • Humans
  • Male
  • Mucormycosis / complications
  • Mucormycosis / diagnostic imaging*
  • Mucormycosis / drug therapy
  • Radiography
  • Respiratory Tract Infections / complications
  • Respiratory Tract Infections / diagnostic imaging*
  • Respiratory Tract Infections / drug therapy

Substances

  • Antifungal Agents