Pulmonary mucormycosis in a patient with acute liver failure: A case report and systematic review of the literature

J Crit Care. 2020 Apr;56:89-93. doi: 10.1016/j.jcrc.2019.12.012. Epub 2019 Dec 12.


Purpose: Pulmonary mucormycosis is a highly lethal invasive fungal infection usually found in immunocompromised patients. We report herein the case of an adult woman who developed pulmonary mucormycosis with possible systemic dissemination after recovering from acute liver failure secondary to acetaminophen overdose.

Results: Our case developed an invasive pulmonary mucormycosis with probable systemic dissemination. She did not suffer from any immunocompromising disease other than severe acute liver failure. She did not survive the disease, although she received appropriate antifungal treatment. We also performed a systematic review of the literature on pulmonary mucormycosis, with or without dissemination, in immunocompetent patients. We found 16 cases of pulmonary or disseminated mucormycosis in immunocompetent patients. Fifty-seven percent of them died and none occurred after an acute liver failure episode.

Conclusion: This case report is the first one to present an invasive pulmonary mucormycosis infection after acute liver failure in an adult patient. The clinical course of this disease is highly lethal, even in immunocompetent adults.

Keywords: Acute liver failure; Disseminated mucormycosis; Immunocompetent host; Pulmonary mucormycosis; Systematic review.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Acetaminophen / toxicity*
  • Antifungal Agents / therapeutic use
  • Brain / diagnostic imaging
  • Drug Overdose / complications*
  • Drug Overdose / microbiology
  • Female
  • Humans
  • Immunocompromised Host
  • Liver Failure, Acute / complications*
  • Liver Failure, Acute / microbiology
  • Lung
  • Lung Diseases / complications*
  • Lung Diseases / microbiology
  • Middle Aged
  • Mucorales
  • Mucormycosis / complications*
  • Mucormycosis / microbiology
  • Respiratory Tract Infections / complications
  • Tomography, X-Ray Computed


  • Antifungal Agents
  • Acetaminophen