Rapidly Fatal Pulmonary Mucormycosis With Pericardial Dissemination: A Case Report and Imaging Insights

Mucormycosis is a rare but aggressive opportunistic fungal infection, predominantly affecting immunocompromised individuals. We report a case of a 59-year-old male with newly diagnosed acute myeloid leukemia undergoing chemotherapy who developed pulmonary mucormycosis, which rapidly progressed to disseminated disease with pericardial involvement, an exceptionally rare occurrence. Initial chest CT imaging showed a subtle perihilar infiltrate, but within days, extensive spread was evident, showing widespread pulmonary consolidation, ground-glass opacities, vascular thrombosis, mediastinal invasion, and pericardial involvement. Bronchoscopy confirmed airway obstruction due to fungal invasion, and biopsy, along with pericardial fluid cultures, revealed Rhizopus microsporus. Despite early antifungal treatment, the patient's condition worsened, making surgery impossible and leading to respiratory failure and death. This case underscores the rapid progression and extensive spread of mucormycosis, highlighting the critical role of early CT imaging and clinical vigilance in high-risk patients. Timely recognition and intervention are essential to improve outcomes through both early medical and possible surgical management in this often-fatal disease.