Overview
Pulmonary mucormycosis (PM) is a rare but aggressive fungal infection primarily affecting immunocompromised individuals, often complicated by COVID-19 in recent cases, leading to severe outcomes including pulmonary artery pseudoaneurysm (PAP). 1Diagnosis
Clinico-radiological suspicion essential for initial identification.
Confirmed by microbiology or histopathology.
Imaging (CT scans) crucial for detecting complications like PAP.
Elevated D-dimer levels may correlate with severity but not specific. 1Management
First-line treatments: Surgical debridement for localized disease.
Antifungal therapy: Amphotericin B (typically 0.7-1 mg/kg/day) as primary agent.
Adjunctive treatments: Postoperative care, control of underlying conditions (e.g., diabetes).
Multimodal approach: Combining surgical intervention with antifungal medications critical. 1Special Populations
Diabetes: Common comorbidity in reported cases, significantly impacts mortality. 1
Elderly: Higher risk noted in older adults (55-62 years in cases). 1
COVID-19: Comorbid infection increases complexity and mortality risk. 1Key Recommendations
Early diagnosis through clinico-radiological evaluation and confirmatory tests is crucial for improving outcomes (Evidence: Weak) 1
Multimodal management including surgical intervention and antifungal therapy (Amphotericin B) is recommended for better survival rates (Evidence: Weak) 1
Strict control and management of underlying conditions, particularly diabetes, is essential to reduce mortality risk (Evidence: Weak) 1References
1 Pruthi H, Muthu V, Bhujade H, Sharma A, Baloji A, Ratnakara RG et al.. Pulmonary Artery Pseudoaneurysm in COVID-19-Associated Pulmonary Mucormycosis: Case Series and Systematic Review of the Literature. Mycopathologia 2022. link