[Mucormycosis in the diabetic patient]

INTRODUCTION

Mucormycosis is a rare, devastating, fungal infection, which disproportionately affects non-controlled diabetic patients, notably during ketoacidosis. It can be manifested in rhinocerebral, but also pulmonary and disseminated forms.

OBSERVATIONS

Four consecutive diabetic patients who were admitted to the Farhat Hached Hospital, Sousse, Tunisia, between January 2001 and November 2002, are presented. Three patients exhibited ketoacidosis and one renal failure with hyperosmolarity. Infection was limited to the sinuses in two cases, to lower respiratory tract in one case, and was probably disseminated in one case. Diagnosis was confirmed by mycological and histological findings in all cases. Systemic Amphotericin B was associated with surgical debridement of the lesions in patients with rhinocerebral involvement.

DISCUSSION

Despite aggressive therapy, mortality was high (3 out of 4 patients). Mucormycosis remains a severe, frequently fatal disease in diabetic patients.

Management of Bronchovascular Mucormycosis in a Diabetic: A Surgical Success

Although cases of pulmonary mucor are scarce, diabetics account for a large percentage of these patients. The synergism of diabetes mellitus and mucormycosis poses potentially devastating bronchopulmonary complications, warranting urgent intervention. This report reviews the efficient workup, along with successful medical and surgical management, of a patient with pulmonary mucormycosis, with evidence of superior vena cava invasion.