SHM Converge Scientific Abstract ePoster Gallery-A Case of Pulmonary Mucormycosis in Type 1 Diabetes Mellitus

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This case describes a 50-year-old woman with type 1 diabetes mellitus, alcohol use disorder, and mood disorder who was admitted after being found down and initially treated for diabetic ketoacidosis. She was presumed to have bacterial pneumonia based on a right middle lobe consolidation and was treated with broad-spectrum antibiotics. However, her oxygen requirement persisted, imaging worsened, and she developed multiple cavitary lung lesions and ground-glass opacities.<br /><br />Bronchoscopy revealed copious yellow secretions with necrotic, black mucosa, and bronchial biopsy showed ribbon-like, non-septate hyphae with wide-angle branching, findings consistent with mucormycosis. Sputum cultures also grew Rhizopus species, Candida, and MSSA. She was started on liposomal amphotericin B on hospital day 17, but follow-up CT chest showed progression with interval enlargement of cavitary lesions in both upper lobes.<br /><br />Because the infection was bilateral, surgical resection was not an option. Despite antifungal therapy, the disease continued to progress, leaving no further escalation available and a high likelihood of death from respiratory failure. The patient was discharged home with hospice.<br /><br />The presentation emphasizes that pulmonary mucormycosis, though less common than rhino-orbital-cerebral disease, should be considered in patients with diabetes and immunocompromise, especially when pneumonia does not improve with standard antibiotics. It is associated with very high mortality, reportedly up to 80–90%. Early recognition, fungal cultures, bronchoscopy, prompt antifungal therapy, and surgical consultation are critical to improving outcomes.

Asset Subtitle

Kimiya Nourian

Meta Tag

Author List Andrew Bryant, Kimiya Nourian

Category Clinical Vignettes

Concept Mucormycosis

Concept Pulmonary mucormycosis

Concept Diabetes Mellitus

Concept Antifungal Therapy

Concept Rhino-orbital-cerebral mucormycosis

Distinguished Non-Finalist

Presenter Organization University of Iowa Hospitals and Clinics

Presenting Author Kimiya Nourian

Track Adult

Keywords

pulmonary mucormycosis

type 1 diabetes mellitus

diabetic ketoacidosis

cavitary lung lesions

ground-glass opacities

bronchoscopy

Rhizopus species

liposomal amphotericin B

fungal infection

respiratory failure

Mucormycosis

Pulmonary mucormycosis

Diabetes Mellitus

Antifungal Therapy

Rhino-orbital-cerebral mucormycosis