Bronchial stent implantation in patient with bronchial obstruction caused by pulmonary mucormycosis: a case report.

Abstract

Background: Pulmonary mucormycosis (PM) is an acute suppurative lung disease caused by any fungus in the order Mucorales. PM is characterized by its propensity for vascular invasion, rapid progression, and destructiveness, leading to a high mortality rate.

Case description: A 39-year-old male patient was diagnosed with PM and complicated by bronchial obstruction. Although surgical debridement of mucormycosis and antifungal therapy are generally preferred treatment, our patient presented with a high burden of invasive disease and was deemed ineligible for surgery. We therefore had to compromise and palliate his bronchial obstruction with a bronchial stent while continuing intravenous, nebulized, and bronchoscopically applied antifungals. The intervention markedly alleviated the patient's symptoms of chest tightness and dyspnea. However, given the advanced stage at presentation, the prognosis was already poor. Despite these measures, the aggressive underlying infection continued to progress, ultimately leading to erosion into a major vessel and catastrophic hemoptysis.

Conclusions: The implantation of bronchial stents in patients with PM can effectively alleviate severe bronchial obstruction caused by mucormycosis infection, improve pus drainage, and promote infection resolution. However, as a complete surgical resection of the lesion was not performed, the patient remains at risk of potentially catastrophic hemoptysis due to the possibility of pulmonary vascular invasion by mucormycosis. The potential increase in hemoptysis risk associated with stent implantation warrants further investigation.