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Eur J Cardiothorac Surg 2002;21:940-942
© 2002 Elsevier Science NL

Case report

Persistent cavitations in pulmonary mucormycosis after apparently successful amphotericin B

^a Department of Pulmonology, Hospital Doce de Octubre, Carretera de Andalucía km 5.4, CP 28041 Madrid, Spain
^b Department of Thoracic Surgery, Hospital Doce de Octubre, Carretera de Andalucía km 5.4, CP 28041 Madrid, Spain

Received 3 December 2001; received in revised form 16 January 2002; accepted 31 January 2002.

* Corresponding author. Tel.: +34-91-390-82-49; fax: +34-91-469-57-75
e-mail: jrdonado{at}arrakis.es

A 67-year-old diabetic male developed bilateral pulmonary mucormycosis (PM). After long-term treatment with amphotericin B (cumulative dose of 30.6 g), clinical resolution was obtained, but small radiographic cavitations persisted. A late relapse occurred and bilateral lobectomy led to a definitive cure. Amphotericin B is not able to penetrate properly into PM cavitations. We suggest that persistence of cavitations should lead to consideration of surgery, even after a good response to amphotericin B.

Key Words: Pulmonary mucormycosis • Diabetes • Cavitation • Amphotericin B • Surgery