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Pulmonary Mucormycosis Presenting as Non-resolving Pneumonia in an Elderly Patient With Uncontrolled Diabetes
Thayani Raja1, Nirasha Jayathilake2, Manil Peiris2
1Internal Medicine, Batticaloa Teaching Hospital, Batticaloa, LKA.
Abstract:
Pulmonary mucormycosis is an uncommon but highly aggressive opportunistic fungal infection associated with significant morbidity and mortality, particularly in immunocompromised individuals. Early diagnosis remains challenging due to its nonspecific clinical and radiological presentation, often mimicking bacterial pneumonia or other pulmonary infections. We report the case of a 78-year-old woman with poorly controlled type 2 diabetes mellitus who presented with a prolonged history of productive cough, pleuritic chest pain, and intermittent fever. Despite treatment with broad-spectrum antibiotics, her condition failed to improve, prompting further evaluation. Imaging revealed persistent pulmonary consolidation, and bronchoscopy demonstrated necrotic endobronchial lesions. Histopathological examination confirmed the presence of broad, aseptate fungal hyphae, and fungal culture was consistent with mucormycosis. The patient was successfully treated with intravenous liposomal amphotericin B, resulting in significant clinical and radiological improvement. This case highlights the importance of considering invasive fungal infections such as mucormycosis in cases of non-resolving pneumonia, especially in patients with uncontrolled diabetes. Prompt recognition, early initiation of appropriate antifungal therapy, and correction of underlying risk factors are critical in improving patient outcomes.
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