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Case Reports in Infectious Diseases
Volume 2015, Article ID 478789, 5 pages
http://dx.doi.org/10.1155/2015/478789
Case Report

Pulmonary Mucormycosis in a Patient with Systemic Lupus Erythematosus: A Diagnostic and Treatment Challenge

1Division of Gastroenterology, Department of Internal Medicine, Nantou Hospital, Ministry of Health and Welfare, No. 478, Fuxing Road, Nantou City, Nantou County 540, Taiwan
2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chiu General Hospital, No. 137, Chenggong First Road, Lingya District, Kaohsiung 802, Taiwan
3Department of Family and Community Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan
4School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan
5Institute of Medicine and School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan
6Division of Allergy, Immunology, Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan
7Division of Infectious Diseases, Department of Internal Medicine, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung 402, Taiwan
8Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, Sanmin Road, Taichung 403, Taiwan

Received 24 February 2015; Revised 1 June 2015; Accepted 3 June 2015

Academic Editor: Larry M. Bush

Copyright © 2015 Hung-Chang Hung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pulmonary mucormycosis is commonly encountered in patients with diabetic ketoacidosis, hematologic malignancies, neutropenia, organ or hematopoietic stem cell transplantation, and malignancy, but it rarely occurs in high-risk patients with systemic lupus erythematosus (SLE). We present the case of a 40-year-old SLE female with fulminant pneumonia after remission of nephritis treated with rituximab, who developed severe pulmonary mucormycosis that led to her rapid death from acute respiratory failure and acute respiratory distress syndrome. Pulmonary mucormycosis has a high mortality rate. However, with early diagnosis and antifungal therapy with lipid formulation-liposomal amphotericin B and surgical removal of the infected area, the outcome can be improved.