Case Report: Liquid-based cytology diagnosis of pulmonary mucormycosis

Summary

A 41-year-old man with diabetes developed a serious lung infection caused by mucormycosis, a rare and dangerous fungus. Doctors diagnosed the infection using liquid-based cytology, a technique that examines fluid from the lungs under a microscope, which proved more effective than traditional methods. Treatment with antifungal medications helped stabilize the patient’s condition, and he remained healthy during an eight-month follow-up. This case highlights how advanced diagnostic techniques can help doctors quickly identify and treat severe fungal infections.

Background

Mucormycosis is a rare and life-threatening opportunistic fungal infection that commonly arises as a complication of diabetic ketoacidosis, with a case fatality rate of 70-90%. Timely diagnosis is essential but difficult due to non-specific clinical manifestations and limited diagnostic specificity of auxiliary examinations. This case demonstrates the successful diagnosis of pulmonary mucormycosis using multiple cytological and histopathological approaches.

Objective

To document a case of pulmonary mucormycosis identified through conventional cytological smear, liquid-based cytology, and cell block preparation in a 41-year-old male patient with type 2 diabetes mellitus presenting with productive cough, fever, and hemoptysis.

Results

Cytological examination revealed broad, ribbon-like filamentous structures with right-angle branching characteristic of mucormycosis. Liquid-based cytology provided superior diagnostic yield with clearer three-dimensional features compared to conventional smears. Histopathological biopsy confirmed wide tubular hyphae (10-15 μm diameter) with minimal branching, and specialized staining delineated fungal walls distinctly.

Conclusion

Liquid-based cytology and cell block preparations offer non-invasive and expedient alternatives to conventional diagnostic approaches for pulmonary mucormycosis, with diagnostic accuracy comparable to histopathological examination. These techniques enable early identification and prompt therapeutic intervention, contributing to improved clinical outcomes.
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