Pneumonectomy in pulmonary mucormycosis complicating Behçet's disease

Abstract

Summary A 37 year old man with Behçet's disease who was maintained on prolonged corticosteroid therapy, developed diabetic ketoacidosis and pneumonia. Secondary infection with mucor intervened with abscess formation cured by pneumonectomy. The association of Behçet's disease and mucormycosis has not been previously reported, although diabetes mellitus was almost certainly the predisposing cause. Surgical treatment offers the best chance of survival in similar cases.

Behçet's Disease with Bilateral Renal Infarction Due to Mucormycosis

“…Santo et al reported a case of Behçet's disease complicated with pulmonary mucormycosis that was treated by high-dose corticosteroids. To our knowledge, our case is the first of renal mucormycosis with Behçet's disease (6). Anti- TNF inhibitors are potent immunosuppressive medications that are licensed for the treatment of a variety of autoimmune diseases, including Behçet's disease, rheumatoid arthritis, and Crohn's disease (7).…”

“…Mucormycosis is characterized by the uniform presence of extensive angioinvasion with resultant vessel thrombosis and tissue necrosis. This is associated with penetration through the endothelial lining of blood vessels and hematogenous dissemination of fungus from the original site of infection to other organs (4,6,14,19,24), cardiovascular lesions, brain infarction, pulmonary infarction, and renal infarction. Renal failure is caused by occlusion of the renal arteries and/or their branches, as documented in our patient.…”

Infection and Behçet Disease

“…Although no systematic review regarding this issue has been published, several reports [59][60][61][62][63][64][65][66][67][68][69][70] have described important opportunistic infections secondary to bacteria, fungal, protozoa and viral agents. Although no systematic review regarding this issue has been published, several reports [59][60][61][62][63][64][65][66][67][68][69][70] have described important opportunistic infections secondary to bacteria, fungal, protozoa and viral agents.…”

“…Although no systematic review regarding this issue has been published, several reports [59][60][61][62][63][64][65][66][67][68][69][70] have described important opportunistic infections secondary to bacteria, fungal, protozoa and viral agents. A wide spectrum of microbiologic agents 63,[74][75][76] can complicate the use of steroids, including gram-negative or -positive bacteria, 67,68 mycobacteria, fungi 69 and virus. Corticosteroid actions [71][72][73] result in a qualitative defect of phagocytic function, neutropenia, lymphocytopenia, suppression of normal delayed hypersensitivity reactions and, in high doses, defective humoral immunity.…”