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Open Access Highly Accessed Case report

A rapidly progressing Pancoast syndrome due to pulmonary mucormycosis: a case report

Meghana Bansal1*, Sara R Martin2, Stacy A Rudnicki3, Kim M Hiatt4 and Eduardo Mireles-Cabodevila2

Author Affiliations

1 Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

2 Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

3 Division of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

4 Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

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Journal of Medical Case Reports 2011, 5:388  doi:10.1186/1752-1947-5-388

Published: 17 August 2011

Abstract

Introduction

Pancoast syndrome is characterized by Horner syndrome, shoulder pain radiating down the arm, compression of the brachial blood vessels, and, in long-standing cases, atrophy of the arm and hand muscles. It is most commonly associated with lung carcinoma but rarely is seen with certain infections.

Case presentation

We present the case of a 51-year-old Caucasian man who had acute myeloid leukemia and who developed a rapidly fulminating pneumonia along with signs and symptoms of acute brachial plexopathy and left Horner syndrome. Also, a purpuric plaque developed over his left chest wall and progressed to skin necrosis. The skin biopsy and bronchoalveolar lavage showed a Rhizopus species, leading to a diagnosis of mucormycosis. This is a rare case of pneumonia due to mucormycosis associated with acute Pancoast syndrome.

Conclusions

According to our review of the literature, only a few infectious agents have been reported to be associated with Pancoast syndrome. We found only three case reports of mucormycosis associated with acute Pancoast syndrome. Clinicians should consider mucormycosis in their differential diagnosis in a patient with pulmonary lesions and chest wall invasion with or without neurological symptoms, especially in the setting of neutropenia or other immunosuppressed conditions. It is important to recognize this condition early in order to target therapy and interventions.