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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Chronic pulmonary mucormycosis caused by rhizopus microsporus mimics lung carcinoma in an immunocompetent adult: A case report
Xing-Zi Guo, Liang-Hui Gong, Wen-Xiang Wang, De-Song Yang, Bai-Hua Zhang, Ze-Tao Zhou, Xiao-Hui Yu
Xing-Zi Guo, Department of Gynecologic Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
Liang-Hui Gong, Wen-Xiang Wang, De-Song Yang, Bai-Hua Zhang, The Second Department of Thoracic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
Ze-Tao Zhou, GZMU-GIBH School of Life Sciences, Guangzhou Medical University, Guangzhou 511436, Guangdong Province, China
Xiao-Hui Yu, Department of Pathology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410031, Hunan Province, China
Author contributions: Guo XZ, Gong LH, Wang WX, Yang DS, Zhang BH, and Zhou ZT contributed to manuscript writing and editing; Yu XH contributed to conceptualization and supervision; and all authors have read and approved the final manuscript.
Supported by Hunan Provincial Natural Science Foundation of China, No. 2022JJ40247 and No. 2022JJ40256.
Informed consent statement: We obtained informed written consent from the patient to publish this case report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xiao-Hui Yu, MD, PhD, Doctor, Department of Pathology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Tongzipo Road, Yuelu District, Changsha 410031, Hunan Province, China. yuxiaohui@hnca.org.cn
Received: January 7, 2023
Peer-review started: January 7, 2023
First decision: March 24, 2023
Revised: April 2, 2023
Accepted: April 12, 2023
Article in press: April 12, 2023
Published online: May 16, 2023
BACKGROUND
Pulmonary mucormycosis is a rare but life-threatening invasive fungal infection that mostly affects immunocompromised patients. This disease usually develops acutely and progresses rapidly, often leading to a poor clinical prognosis. Chronic pulmonary mucormycosis is highly unusual in immunocompetent patients.
CASE SUMMARY
A 43-year-old man, who was a house improvement worker with a long history of occupational dust exposure, presented with an irritating cough that had lasted for two months. The patient was previously in good health, without dysglycemia or any known immunodeficiencies. Chest computed tomography revealed a mass in the left lower lobe, measuring approximately 6 cm in diameter, which was suspected to be primary lung carcinoma complicated with obstructive pneumonia. Thoracoscopic-assisted left lower lobectomy was performed, and metagenomic next-generation sequencing detection, along with special pathological staining of surgical specimens, suggested Rhizopus microsporus infection. Postoperatively, the patient's respiratory symptoms were relieved, and no signs of recurrence were found during the six-month follow-up.
CONCLUSION
This article reports a rare case of chronic pulmonary mucormycosis caused by Rhizopus microsporus in a middle-aged male without dysglycemia or immunodeficiency. The patient's surgical outcome was excellent, reaffirming that surgery remains the cornerstone of pulmonary mucormycosis treatment.
Core Tip: Pulmonary mucormycosis is a rare yet life-threatening invasive fungal infection that typically affects immunocompromised patients. In this report, we present a case of chronic pulmonary mucormycosis in a 43-year-old immunocompetent house improvement worker. The patient initially presented with an irritating cough and a solitary mass in the left lower lobe, which raised concerns of primary lung carcinoma. A successful thoracoscopic-assisted left lower lobectomy was performed, and subsequent metagenomic next-generation sequencing analysis and specialized pathological staining of surgical specimens suggested Rhizopus microsporus as the causative agent of the infection. During a six-month postoperative follow-up, no signs of recurrence were observed.
