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Pulmonary Mucormycosis in Diabetic Patients: A Case Series From a Tertiary Respiratory Center in Sri Lanka

Summary

This case study describes three diabetic patients in Sri Lanka who developed a serious lung infection caused by a fungus called mucormycosis. The infection caused cavities in the lungs and symptoms like fever, cough, and weight loss. Two patients recovered with antifungal medication (amphotericin B) and surgery, while one patient sadly died despite receiving treatment. The study emphasizes that doctors should consider this infection in diabetic patients with unusual lung symptoms to catch it early.

Background

Pulmonary mucormycosis is a rare but aggressive fungal infection that primarily affects immunocompromised individuals, especially those with uncontrolled diabetes mellitus. Its non-specific presentation can mimic more common pulmonary conditions, often resulting in delayed diagnosis and treatment. The incidence of pulmonary mucormycosis has been increasingly recognized in diabetic populations, particularly in tropical and resource-limited settings.

Objective

To present a case series of three Sri Lankan patients with type 2 diabetes mellitus who developed pulmonary mucormycosis and illustrate the diverse clinical spectrum, diagnostic challenges, and outcomes associated with this life-threatening infection.

Results

Three patients presented with variable respiratory and constitutional symptoms including fever, cough, and weight loss. Imaging revealed cavitary lesions and pleural effusions. Two patients were successfully treated with prolonged intravenous liposomal amphotericin B therapy (56 days), while one patient rapidly deteriorated and died despite early antifungal initiation. All treated patients experienced hypokalemia and hypomagnesemia during treatment.

Conclusion

Pulmonary mucormycosis should be actively considered in diabetic patients presenting with persistent or atypical respiratory symptoms, particularly when imaging reveals cavitary lesions or necrotizing pneumonia. Early diagnosis via bronchoscopy or surgical sampling combined with timely initiation of antifungal therapy can significantly influence outcomes. In resource-limited settings, timely recognition and early diagnostic workup are crucial to minimizing morbidity and mortality.
  • Published in:Cureus,
  • Study Type:Case Series,
  • Source: PMID: 40831878, DOI: 10.7759/cureus.88260
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