Pediatric pulmonary mucormycosis in a diabetic patient treated with extended pleurectomy and Clagett procedure

• Published in: Journal of pediatric surgery case reports Vol. 45; p. 101210
• Main Authors: Gologorsky, Rebecca C, Ely, Sora, Rothenberg, Kara A, Glaser, Carol, Velotta, Jeffrey B
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-06-2019; Elsevier
• Subjects: Clagett procedure; Diabetes; Mucormycosis; Pediatric thoracic surgery; Pneumonectomy; Pulmonary mucormycosis; Surgery; Mucormycosis; Pulmonary mucormycosis; Diabetes; Pneumonectomy; Clagett procedure; Pediatric thoracic surgery
• ISSN: 2213-5766; 2213-5766
• DOI: 10.1016/j.epsc.2019.101210

Abstract Mucor is a ubiquitous fungus that is non-pathogenic in healthy people. In immunocompromised hosts, nonfunctional or absent neutrophils and macrophages result in fungal invasion and infection [1]. Invasive mucor (mucormycosis) most commonly involves the sinuses, brain, or lungs. Pulmonary mucormycosis typically presents in patients with a history of organ transplantation or hematologic malignancy [2], and is rare in patients with diabetes alone. The epidemiology and management of pediatric pulmonary mucormycosis is poorly described. We report an unusual occurrence of this disease, complicated by segmental pulmonary artery thrombus in a 15-year-old with poorly controlled diabetes. His severe, medication-resistant infection was ultimately treated successfully with antifungal medication combined with aggressive surgical debridement. The pulmonary artery segmental thrombus resolved after treatment of the underlying infection without anticoagulation.