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Tracheal mucormycosis presented as an intraluminal soft tissue mass

Authors

  • Omer Wolf MD,

    1. Department of Otolaryngology Head & Neck Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Ziv Gil MD, PhD,

    Corresponding author
    1. Department of Otolaryngology Head & Neck Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
    • and Ziv Gil, Department of Otolaryngology Head and Neck Surgery. Tel-Aviv Sourasky Medical Center, Tel-Aviv 64239, Israel
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  • Leonor Leider-Trejo MD,

    1. The Pathological Institute, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Avi Khafif MD,

    1. Department of Otolaryngology Head & Neck Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Philippe Biderman MD,

    1. The Intensive Care Unit, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Dan M. Fliss MD

    Corresponding author
    1. Department of Otolaryngology Head & Neck Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
    • and Ziv Gil, Department of Otolaryngology Head and Neck Surgery. Tel-Aviv Sourasky Medical Center, Tel-Aviv 64239, Israel
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Abstract

Background.

Mucormycosis is a potentially lethal disease caused by an opportunistic fungal infection. It occurs mostly in diabetic or immunosuppressed patients and usually involves the lungs or paranasal sinuses.

Methods.

We report a rare case of a patient with diabetic ketoacidosis who presented with progressive cough and dyspnea. CT of the neck and chest showed an intraluminal soft-tissue mass extending from the first tracheal ring to the thoracic inlet, causing severe destruction of the trachea. Direct laryngoscopy and biopsy demonstrated hyphal invasion with architecture typical of invasive mucormycosis.

Results.

The patient underwent resection of the upper trachea and prolonged amphotericin B therapy and is disease free at 24 months after surgery.

Conclusions.

In patients with diabetes presenting with progressive hoarseness, dyspnea, and endobronchial mass, a fungal infection should be considered. In case of invasive tracheal mucormycosis, prompt diagnosis and early surgical resection may help improve survival. © 2004 Wiley Periodicals, Inc. Head Neck26: 541–543, 2004

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