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

Abstract

Abstract 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.

Keywords

• Mucormycosis
• Tracheobronchial mucormycosis
• Amphotericin B
• Liposomal amphotericin B
• Isavuconazole
• Posaconazole