Tracheobronchial mucormycosis successfully treated with venous-venous extracorporeal membrane oxygenation combined with prolonged amphotericin B instillation by Bronchoscopy: a case report

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2024年11月14日

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Ying Xu,
Pei Liang,
Zhifeng Zhang,
Yingying Hao,
Zilan Yan,
Danjiang Dong,
Qin Gu

摘要

Background

Tracheobronchial mucormycosis is a fatal opportunistic infection that mainly causes airway stenosis and is difficult to manage clinically.

Case presentation

We report a case of severe tracheal stenosis caused by tracheobronchial mucormycosis in a 37-year-old female with a history of hyperthyroidism. She developed agranulopenia after oral methimazole administration and subsequently experienced asthma with dyspnea. Bronchoscopy, sputum culture, colony mass spectrometry, and microscopic cotton orchid staining confirmed tracheobronchial mucormycosis. The patient received venous-venous extracorporeal membrane oxygenation (VV-ECMO) and prolonged intratracheal instillation of amphotericin B (AmBD), combined with amphotericin B liposome (L-AmB) and isavuconazole intravenous infusion, ultimately resulting in successful treatment.

Conclusion

VV-ECMO combined with prolonged intratracheal instillation of AmBD is an effective method for the treatment of tracheobronchial mucormycosis.