{
  "abstract": "The airway course after relief of severe necrotic tracheobronchial obstruction in disseminated mucormycosis remains poorly described. We report a 53-year-old man with poorly controlled diabetes mellitus who developed disseminated pulmonary and cerebral mucormycosis caused by Rhizopus species. Despite initial treatment, extensive necrotic tracheobronchial obstruction progressed, with complete occlusion of the right middle lobe bronchus and multilevel obstruction of the left upper lobe and right lower lobe bronchi. Systemic antifungal therapy and repeated bronchoscopic interventions, including necrotic tissue debridement and local amphotericin B instillation were associated with progressive clearance of necrosis, restoration of airway patency, and improvement of pulmonary and cerebral disease. Bronchoscopic interventions were initially performed two to three times weekly, with local amphotericin B at 25-35 mg per session. As previously occluded bronchi reopened, access to additional affected bronchi expanded the treatment area, the dose increased to 45-50 mg per session to cover additional affected areas, while intervention frequency. decreased to weekly. Further improvement allowed reduction of the local dose to 20 mg per session and less frequent interventions. Systemic antifungal therapy was discontinued at Month 12, but intermittent bronchoscopic interventions, including local amphotericin B instillation, continued through Month 25 because of the severity of the preceding endobronchial disease, persistent bronchial narrowing, and impaired secretion clearance. No recurrent extensive necrotic obstruction was observed. This case suggests a potential adjunctive role for bronchoscopic amphotericin B in selected patients with severe necrotic tracheobronchial mucormycosis and illustrates the need for continued airway surveillance and secretion clearance after relief of obstruction.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Respiratory and Critical Care Medicine, Emergency General Hospital, Beijing, China.",
    "Department of Medicine Solna, Karolinska Institutet, and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jieli Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yongping Gao"
    },
    {
      "affs": [
        0
      ],
      "name": "Fang Qin"
    },
    {
      "affs": [
        0
      ],
      "name": "Peng Zhang"
    },
    {
      "affs": [
        1
      ],
      "name": "Jing Gao"
    },
    {
      "affs": [
        0
      ],
      "name": "Yunzhi Zhou"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/600vq9dc9syw6.bib",
  "cited_by": 0,
  "doi": "10.1016/j.rmcr.2026.102526",
  "fulltext_url": "https://europepmc.org/articles/PMC13742201",
  "id": "600vq9dc9syw6",
  "issns": [
    "2213-0071"
  ],
  "landing_url": "https://europepmc.org/article/MED/42997491",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|Antifungal resistance and susceptibility"
    ]
  ],
  "openalex": "W7224085361",
  "pdf_url": "https://europepmc.org/articles/PMC13742201?pdf=render",
  "pmcid": "PMC13742201",
  "pmid": "42997491",
  "published": "2026-10-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/600vq9dc9syw6.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:34Z",
      "native_id": "MED:42997491",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42997491"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Antifungal resistance and susceptibility",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Prolonged bronchoscopic management after relief of severe necrotic tracheobronchial obstruction in disseminated mucormycosis: a case report.",
  "title_text": "Prolonged bronchoscopic management after relief of severe necrotic tracheobronchial obstruction in disseminated mucormycosis: a case report.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:34Z",
  "url": "https://research.draconitic.com/paper/600vq9dc9syw6",
  "venue": "Respiratory medicine case reports",
  "versions": []
}