Endobronchial Administration of Amphotericin B Deoxycholate as an Adjunctive Treatment for Pulmonary Mucormycosis Unresponsive to Posaconazole: A Retrospective Case Review

Category	Detail
Condition	Pulmonary Mucormycosis
Key Mechanisms	Invasive fungal infection characterized by angioinvasion leading to tissue necrosis and obstruction.
Target Population	Immunocompromised individuals, particularly those with hematologic malignancies or chronic lung diseases.
Care Setting	Retrospective case series conducted in a hospital setting.

Five patients with pulmonary mucormycosis unresponsive to posaconazole received local amphotericin B deoxycholate.
Bronchoscopic airway clearance was performed prior to local drug administration.
No adverse events related to the local procedure were reported.
Follow-up CT scans showed partial absorption or shrinkage of pulmonary lesions in all patients.
All patients had significant underlying conditions contributing to their immunocompromised status.

Diagnosis of pulmonary mucormycosis should include clinical assessment, imaging, and microbiological confirmation.

First-line treatment is liposomal amphotericin B; posaconazole may be used as salvage therapy.

Monitor for clinical deterioration and radiologic progression during antifungal therapy.

Inadequate response to systemic antifungal therapy can lead to increased mortality and poor clinical outcomes.

Patients diagnosed with pulmonary mucormycosis who are unresponsive to posaconazole.

Local administration of amphotericin B deoxycholate may enhance local control in cases of airway obstruction.

Consider bronchoscopic airway clearance in patients with obstructive pulmonary lesions.
Evaluate the need for local amphotericin B administration in cases of treatment failure with systemic antifungals.

Clinical Scorecard: Endobronchial Administration of Amphotericin B Deoxycholate as an Adjunctive Treatment for Pulmonary Mucormycosis Unresponsive to Posaconazole: A Retrospective Case Review