Unexpected Disappearance Of A Mycetoma
Chen, H. C., Wu, S. H., & Hsiao, Y. C. (2012). Unexpected disappearance of a mycetoma. The American journal of the medical sciences, 343(3), 243. https://doi.org/10.1097/MAJ.0b013e31822d99d6
View Original Source →Case Details
Disease Location
Lungs
Personal Characteristics
49 -year-old woman history of type 2 diabetes mellitus and alcoholic liver disease
Clinical Characteristics
Experienced several episodes of hemoptysis in the past 2 years later was admitted to our medical intensive care unit because of massive hemoptysis, hemodynamic instability and respiratory failure. Chest roentgenography revealed a large ball-inhole lesion in the right upper lung field, along with bilateral alveolar infiltration blood samples tested positive for aspergillus galactomannan antigen patient refused to undergo surgical intervention for fear of the risks
Remission Characteristics
A chest roentgenogram on the same day that voriconazole was discontinued showed no interval change of the right upper lobe lung lesion the follow-up chest roentgenography performed before her discharge showed no lesion in the lung cavity
Treatment & Mechanisms
Proposed Remission Mechanisms
Some researchers have proposed that the spontaneous remission of mycetoma, as seen in our case, could result from nutritional deprivation of the infected pulmonary tissue from nutritional deprivation of the infected pulmonary tissue. Other researchers think that the structure of the fungal mass was relatively loose, and it may have been dislodged during severe cough or aspirated out during sputum suction from the endotracheal tube.
Clinical Treatment
Voriconazole was administered after she was admitted to the icu, but discontinued it later because of deterioration of liver function