گزارش يك مورد موكورمايكوز ريوي در بيمار مبتلا به ديابت

Mucormycosis is an acute and often fatal infection caused by fungi of the class mucorales. There are some clinical types such as rhinocerebral, pulmonary, abdominal and cutaneous, all of which are associated with an underlying disorders. Pulmonary mucormycosis often appears with lymphoma and leukemia and is rarely observed in diabetic patients. To the best of our knowledge, this is the first report in Iran: A 16 - year-old diabetic boy who had been suffering from cough, fever, weight loss , purulent and occasionally bloody sputum, associated with progressive dyspnea was unsuccessfully treated with antibacterial agents and finally referred to Imam Khomeini Hospital in Tabriz. X-ray examination demonstrated a right paracardiac opacity with reduced lung volume. Serum glucose was 215 mg/dl, test for acid fast bacillus ( AFB ) was negative and ESR was high. A severe destruction of carina stretched to the main branches and local tracheal stenosis were revealed through bronchoscopy. There were some fistulae with a massive milky clot in left main bronchus. The clot was taken out after washing and sent to the Medical Mycology Unit, No. 2 Clinical lab of Tabriz University of Medical Sciences. Wet mount study of the speciemen showed wide, branching and nonseptate mycellium and after 48 hours a gray colony with many aerobic mycellia was observed in Sabourad Dextrose Agar medium. Rhizopus was reported as the underlying agent . The patient received amphotericin B and tracheal stenosis treated by Nd-YAG laser and finally got rid of the disease. This article presents such a rare case of mucormycosis in a patient with diabetes mellitus.