{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:42:18Z","timestamp":1762004538258,"version":"3.40.4"},"reference-count":22,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Invasive pulmonary coinfection with<jats:italic>Mucor<\/jats:italic>and<jats:italic>Aspergillus<\/jats:italic>is rare. Bilateral vocal cord paralysis resulting from coinfection with these two fungi to our knowledge has not been reported in the literature. We report a young woman with diabetes who presented with symptoms of community acquired pneumonia in association with hoarseness of voice. Investigations revealed air space consolidation of the right upper lobe, evidence of mediastinal involvement extending into the paratracheal space and entrapment of right upper lobe pulmonary artery. Bronchoscopy revealed bilateral vocal cord paralysis and sloughing of mucosa of the right upper lobe bronchus and the bronchus intermedius. Microbiological and pathological results confirmed<jats:italic>Mucor<\/jats:italic>and<jats:italic>Aspergillus<\/jats:italic>. Extensive vascular and mediastinal involvement precludes surgical debridement. Despite aggressive medical management the patient deteriorated and died of respiratory failure. Strong suspicion of invasive fungal infections in immune compromised patients presenting with unresolving pneumonia and hoarseness of voice, early aggressive treatment is crucial for the patient survival.<\/jats:p>","DOI":"10.1136\/bcr-2013-009615","type":"journal-article","created":{"date-parts":[[2013,8,20]],"date-time":"2013-08-20T14:45:28Z","timestamp":1377009928000},"page":"bcr2013009615","source":"Crossref","is-referenced-by-count":19,"title":["Coinfection of pulmonary mucormycosis and aspergillosis presenting as bilateral vocal cord palsy"],"prefix":"10.1136","volume":"2013","author":[{"given":"Arun H","family":"Mahadevaiah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natarajan","family":"Rajagopalan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahantesh","family":"Patil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivaprasad","family":"C","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,8,20]]},"reference":[{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.1","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1001\/archinte.159.12.1301","article-title":"Pumonary mucormycosis : the last 30\u2005years","volume":"2013","author":"Lee","year":"1999","journal-title":"Arch Intern Med"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.2","first-page":"469","article-title":"Necrosis of nasal cartilage due to mucormycosis in a patient with severe congenital neutropenia due to HAX1 deficiency","volume":"2013","author":"Fahimzad","year":"2008","journal-title":"J Investig Allergol Clin Immunol"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.3","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1007\/s10620-006-9455-z","article-title":"Mucormycosis presenting as recurrent gastric perforation in a patient with Crohn's disease on glucocorticoid, 6-mercaptopurine, and infliximab therapy","volume":"2013","author":"Devlin","year":"2007","journal-title":"Dig Dis Sci"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.4","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.jocn.2006.01.023","article-title":"Pituitary apoplexy due to mucormycosis infection in a patient with an ACTH producing pulmonary tumor","volume":"2013","author":"Salinas-Lara","year":"2008","journal-title":"J Clin Neurosci"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.5","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1177\/014556130808700311","article-title":"An atypical case of fatal zygomycosis: simultaneous cutaneous and laryngeal infection in a patient with a non-neutropenic solid prostatic tumor","volume":"2013","author":"Johnson","year":"2008","journal-title":"Ear Nose Throat J"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.6","first-page":"843","article-title":"Rhinocerebral mucormycosis in a patient with cirrhosis and chronic renal failure","volume":"2013","author":"Georgopoulou","year":"2003","journal-title":"HepatoGastroenterology"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.7","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1128\/CMR.18.3.556-569.2005","article-title":"Novel perspectives on mucormycosis: pathophysiology, presentation, and management","volume":"2013","author":"Spellberg","year":"2005","journal-title":"Clin Microbiol Rev"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.8","first-page":"420","article-title":"Clinical spectrum of pulmonary mucormycosis","volume":"2013","author":"Bigby","year":"1986","journal-title":"Chest"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.9","first-page":"912","article-title":"Pulmonary mucormycosis presenting with recurrent laryngeal nerve palsy","volume":"2013","author":"Suresh","year":"2003","journal-title":"J Assoc Physicians India"},{"key":"2025042709060225000_2013.aug20_1.bcr2013009615.10","unstructured":"Stell PM Maran AGD . 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