细胞科学与治疗杂志
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67 岁男性的呼吸困难、疲劳和全身无力：指南和临床判断之间的患者治疗方法

安东尼奥·乔瓦尼·索利曼多、安东内拉·阿根蒂耶罗、彼得·克劳斯、安娜·鲁克德舍尔、克劳迪娅·科维利、安杰洛·瓦卡和赫尔曼·艾因塞勒

Mucormycosis are an emerging group of life-threatening fungal infections caused by filamentous fungi of the Mucorales family. Mucormycosis are most common in stem-cell transplant recipients and patients with underlying hematologic malignancies, poorly controlled diabetes mellitus, trauma, neutropenia, corticosteroid and deferoxamine therapy due to deficiency of phagocytic function, elevated serum levels of available iron and host-pathogen interaction. The fungi penetrate blood vessels causing endothelial damage and extensive angioinvasion with infarction, necrosis, and thrombosis of different tissues. Mucormycosis carries a very high mortality in cases of pulmonary disease, with even higher rates when there is difficulty establishing the diagnosis. We present a case of 67-year-old man with pulmonary form of mucormycosis presenting as opportunistic infection post induction chemotherapy for acute myeloid leukemia FAB M2. We treated the patient with intravenous amphotericin B for 4 weeks and endobronchial resection, after which he clinically and radiographically improved. Overall, early consideration of mucormycosis can lead to an earlier diagnosis, medical and surgical therapy, and an increased survival rate. Furthermore, we provide a real example of multiple thinking strategies, needed for a patient oriented clinical practice. Overall, this case is a challenging example between clinical judgment and available validated guidelines.