Pulmonary Mucormyosis – an Interdisciplinary Challenge

Abstract

# Introduction In Europe, mucormycosis is predominantly observed in patients with underlying hematological disorders and physicians are accustomed to considering invasive fungal diseases as a potential complication in these patients. However, on a global scale, the most common predisposing condition for mucormycosis is diabetes mellitus, particularly in India. # Case and management A 57-year-old diabetic patient with a history of tobacco use presented with coughing, hemoptysis and weight loss. A computed tomography (CT) scan of the chest showed a cavitating lesion in the right lower lobe with concomitant lymphadenopathy. Pulmonary malignancy was suspected and a bronchoscopy with transbronchial biopsy was performed. Histology revealed invasive fungal disease confirmed as pulmonary mucormycosis by a positive Mucorales-specific and panfungal polymerase chain reaction (PCR). Species identification via sequence analysis demonstrated Rhizopus arrhizus as the causative organism. Treatment with liposomal amphotericin B was initiated and surgical resection was performed. This comprehensive approach resulted in a complete and sustained recovery. # Discussion Mucormycosis is an aggressive and often fatal disease that necessitates fast diagnosis and treatment. We aim to increase awareness among European physicians to consider pulmonary mucormycosis as a possible differential diagnosis in patients with lung lesions and diabetes mellitus. A rapid and interdisciplinary approach may affect the outcome positively. PEER REVIEWED ARTICLE Peer reviewers: Two anonymous peer reviewers. Received: December 16, 2024; Accepted after peer review: January 8, 2024