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Pulmonary mucormycosis: Incidental finding in case of dengue with type 1 diabetes mellitus
Lung India ; 39(SUPPL 1):S53, 2022.
Article in English | EMBASE | ID: covidwho-1857763
ABSTRACT

Background:

Pulmonary Mucormycosis is uncommon but serious opportunistic fungal infection caused by fungi of Mucor genus through spores inhalation. Risk factors are diabetes mellitus, hematologic malignancy, transplant and moderate to severe COVID. Here we present a case of 18- year female, with new onset diabetes mellitus with dengue, finally diagnosed as a case of pulmonary mucormycosis. Case Study 18-year female with high grade fever, dry cough, presented in diabetic ketoacidosis (new onset diabetes). Blood investigations revealed metabolic ketoacidosis, leucocytosis, thrombocytopenia, HbA1C of 14.4, ketone and glucose in urine examination, dengue serology positive. She was admitted in ICU under broad spectrum antibiotics, insulin infusion and platelet transfusion. Chest X-ray suggested bilateral inhomogeneous nodular opacities. Chest computed tomography showed multiple groundglass nodules and focal consolidation. Bronchoscopy done for nonresolving pneumonia suggested crusting at opening of right lowe lobe apical segment. Biopsy taken which resulted in diagnosis of pulmonary mucormycosis. Patient started on oral Posaconazole (300mg) along with insulin to manage diabetes and currently under follow-up.

Discussion:

In our case hyperglycemia, ketoacidosis, dengue all act to suppress innate immune response and provide facultative environment for fungal proliferation. Diagnosis based on both histopathology and cultures. Our patient is young age and clinically/vitally stable, so we started Posaconazole (300mg) while majority of published studies recommended liposomal amphotericin-B.

Conclusion:

Pulmonary mucormycosis can even occur in young age with new-onset type 1 diabetes mellitus.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Lung India Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Lung India Year: 2022 Document Type: Article