{"title":"气管支气管粘液瘤病通过静脉-静脉体外膜氧合联合支气管镜长时间灌注两性霉素 B 成功治疗:病例报告。","authors":"Ying Xu, Pei Liang, Zhifeng Zhang, Yingying Hao, Zilan Yan, Danjiang Dong, Qin Gu","doi":"10.1186/s12879-024-10215-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tracheobronchial mucormycosis is a fatal opportunistic infection that mainly causes airway stenosis and is difficult to manage clinically.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusion: </strong>VV-ECMO combined with prolonged intratracheal instillation of AmBD is an effective method for the treatment of tracheobronchial mucormycosis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"24 1","pages":"1303"},"PeriodicalIF":3.4000,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566427/pdf/","citationCount":"0","resultStr":"{\"title\":\"Tracheobronchial mucormycosis successfully treated with venous-venous extracorporeal membrane oxygenation combined with prolonged amphotericin B instillation by Bronchoscopy: a case report.\",\"authors\":\"Ying Xu, Pei Liang, Zhifeng Zhang, Yingying Hao, Zilan Yan, Danjiang Dong, Qin Gu\",\"doi\":\"10.1186/s12879-024-10215-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Tracheobronchial mucormycosis is a fatal opportunistic infection that mainly causes airway stenosis and is difficult to manage clinically.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Conclusion: </strong>VV-ECMO combined with prolonged intratracheal instillation of AmBD is an effective method for the treatment of tracheobronchial mucormycosis.</p>\",\"PeriodicalId\":8981,\"journal\":{\"name\":\"BMC Infectious Diseases\",\"volume\":\"24 1\",\"pages\":\"1303\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-11-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566427/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12879-024-10215-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12879-024-10215-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
摘要
背景:气管支气管粘液瘤病是一种致命的机会性感染,主要导致气道狭窄,临床上很难处理:我们报告了一例由气管支气管粘液瘤病引起的严重气管狭窄病例,患者为 37 岁女性,有甲状腺功能亢进病史。她口服甲巯咪唑后出现粒细胞减少,随后出现哮喘并伴有呼吸困难。支气管镜检查、痰培养、菌落质谱分析和显微镜下棉兰染色证实了气管支气管粘孢子菌病。患者接受了静脉-静脉体外膜氧合(VV-ECMO)和长时间的两性霉素 B(AmBD)气管内灌注,并结合两性霉素 B 脂质体(L-AmB)和异武康唑静脉输注,最终获得成功治疗:结论:VV-ECMO联合长时间气管内灌注AmBD是治疗气管支气管粘液瘤病的有效方法。
Tracheobronchial mucormycosis successfully treated with venous-venous extracorporeal membrane oxygenation combined with prolonged amphotericin B instillation by Bronchoscopy: a case report.
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.
期刊介绍:
BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.