Isolated tracheal mucormycosis in diabetes mellitus and bronchoscopic management

Dear Editor,

We read the interesting case report on airway mucormycosis by Kaliya et al.^[1] and the accompanying literature review. Isolated tracheal or airway mucormycosis is indeed an uncommon entity. However, several cases,^[2] including a recent systematic review on the topic, have been missed.^[3] Thus, the search strategy employed by the authors is unclear. While the authors discuss surgery and anti-fungal therapy in managing isolated tracheobronchial mucormycosis (ITBM), bronchoscopic management was not highlighted. Notably, nearly 30% of subjects with ITBM may require therapeutic bronchoscopy.^[3] We illustrate the role of bronchoscopy by describing a case of critical central airway obstruction due to ITBM requiring airway stenting.

A 49-year-old man presented with fever, productive cough, and noisy breathing developing over 10 days. He denied haemoptysis, facial swelling, or trauma. There was no recent hospitalization or endotracheal intubation. He had no history of smoking or substance abuse. The physical examination was unremarkable except for stridor at rest. There was a history of poorly controlled diabetes, with glycated haemoglobin of 10.9% at admission. (see more)