Treatment of Endobronchial Mucormycosis with Amphotericin B Via Flexible Bronchoscopy

Abstract

A renal transplant patient presented with cough and dyspnea unrelieved by antibiotic therapy. Bronchoscopy revealed left mainstem obstruction by a gelatinous mass, and the histologic diagnosis was consistent with mucormycosis. After 2 months of systemic amphotericin B, endobronchial biopsy was still positive for fungus. We initiated daily endobronchial instillations of 25 mg amphotericin B mixed in 20 mL sterile water. After 35 days of intravenous and endobronchial therapy, there was histologic and clinical cure. When combined with systemic therapy, the instillation of amphotericin B via bronchoscopy appears to be a safe treatment option for invasive pulmonary mucormycosis.