Publication:

A silent spore: when fungi take over the lung

Pulmonary mucormycosis is a rare but aggressive opportunistic fungal infection, predominantly affecting immunocompromised individuals such as those with poorly controlled diabetes mellitus. This case report describes a 65-year-old diabetic woman who presented with fever, cough, haemoptysis, and rapidly progressing dyspnoea. Initial misdiagnosis as bacterial pneumonia delayed appropriate treatment. High-resolution computed tomography (CT) revealed the reverse halo sign and cavitary lesions, raising suspicion for an invasive fungal infection. Microbiological testing showed broad, aseptate hyphae with right-angle branching on potassium hydroxide (KOH) mount, consistent with mucormycosis, despite negative fungal cultures. She was treated with liposomal amphotericin B and later switched to oral posaconazole due to financial limitations. This case underscores the importance of early imaging and microbiological assessment in high-risk patients, especially those with uncontrolled diabetes. It also highlights diagnostic limitations in resource-constrained settings and the critical need for timely antifungal therapy to improve outcomes in pulmonary mucormycosis. Multimodal diagnosis and clinical vigilance remain essential for survival.