A rapidly progressing pulmonary mucormycosis coinfected with Acinetobacter baumannii

a case report

Abstract

Introduction: 

Mucormycosis is a relatively rare opportunistic fungal infection that may cause fatal invasion of blood vessels. Many complications can develop without correct medical treatment.

Report of a case: 

A 49-year-old man with a history of diabetes presented with high fever, cough and purulent sputum. Blood tests showed diabetic ketoacidosis (DKA). Diagnosis of pulmonary mucormycosis was established by bronchoscopy and biopsy. Due to his poor underlying condition, DKA and hepatorenal failure, he was treated with intravenous amphotericin B instead of surgical resection of the infected area. The patient responded well to the therapy until 8 days after admission when the high fever recurred and sputum culture revealed multidrug-resistant A. baumannii. The patient deteriorated rapidly with multiple organ failure and irreversible shock regardless of active rescue.

Conclusion: 

We present a diabetic case who was admitted with DKA and pulmonary mucormycosis and then coinfected with multidrug-resistant A. baumannii during his stay in hospital that aggravated the illness and caused his death. It highlights the importance of early diagnosis and timely treatment of mucormycosis to save the patient who is often immunocompromised or diabetic. It also lays emphasis on the control of nosocomial infection, which is usually caused by multidrug-resistant microorganisms and may ultimately be life-threatening.