| ironjustice@aol.com 2005-04-14, 8:40 am |
| Pathol Int. 2005 Apr;55(4):202-5. Links
Zygomycosis involving lungs, heart and brain, superimposed on pulmonary
edema.
Tomita T, Ho H, Allen M, Diaz J.
Department of Pathology, Texas Tech university Medical Center, El Paso,
Texas, USA.
Zygomycosis is an uncommon but frequently fatal infection and occurs
mostly in immunosuppressed hosts, whereas approximately 50% of
zygomycosis occurs in diabetic patients. The current patient initially
presented with persistent pulmonary edema secondary to renal failure.
This was the last of four admissions within 1 year for this 68-year-old
woman, for whom the chief complaints were shortness of breath and chest
pain. Her past medical history included insulin-requiring type 2
diabetes and hypertension for 10 years, and chronic heart and renal
failure. She was previously admitted to the hospital for what appeared
to be pulmonary edema secondary to renal failure. In the last admission
the patient developed pulmonary hemorrhage and metabolic acidosis.
Transbronchial biopsy was performed, showing irregular fungal hyphae in
the blood vessels, morphologically consistent with zygomycosis. Central
nervous system computed tomography also revealed a large infarct in the
cerebral hemisphere. The patient died on the seventh hospital day. At
autopsy three organs were extensively involved by zygomycosis: (i)
lungs were diffusely hemorrhagic with acute infarcts; (ii) pericardium
had fibrotic inflammation; and (iii) the left cerebral hemisphere,
cerebellum and pons had large hemorrhagic infarct by zygomycosis
infection. Corticosteroid medication and hemodialysis triggered
increasing hyperglycemia, metabolic acidosis and iron overload, which
contributed to zygomycosis infection that subsequently spread to the
heart and brain as a rare consequence.
PMID: 15826246 [PubMed - in process]
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