Safety and efficacy of bronchoscopic interventions for tracheobronchial mucormycosis: a 27-patient retrospective cohort study

BACKGROUND: Tracheobronchial mucormycosis (TM) is characterized by tracheobronchial obstruction and stenosis. This study describes our clinical experience with bronchoscopic interventions for managing TM. METHODS: A retrospective analysis of TM patients was conducted at the Affiliated Hospital of Yunnan University, with a focus on clinical manifestations and treatment information. RESULTS: A total of 27 patients with TM were included. CT imaging revealed tracheobronchial stenosis (51.9%) and obstructive lesions (33.3%). Bronchoscopy showed mucosal necrosis (92.6%) and lumen obstruction (22.2%). All patients received at least one endoscopic intervention or bronchoscopic AmBD instillation. Bronchoscopic AmBD instillation was administered to 26 patients (96.3%), averaging 5.7 sessions per patient. Bronchoscopic intervention was performed in 19 patients (70.4%), averaging 4.1 sessions per patient. Common techniques included argon plasma coagulation (12 patients, 33 procedures), electrocautery (13 patients, 21 procedures) and cryotherapy (8 patients, 19 procedures). Mild bleeding occurred in 29.6% of cases during interventions. Follow-up data showed complete remission in 16 patients (59.3%), improvement in 4 (14.8%), and death in 7 (25.9%). CONCLUSION: To date, this constitutes the largest reported case series of TM. Notably, bronchoscopic treatment, comprising AmBD instillation and interventional therapy, serves as a safe and effective approach in the comprehensive management of TM.