# Pulmonary Mucormycosis: Beyond Classic COVID-19-Associated Fungal Infections

## TL;DR

This paper discusses a rare case of pulmonary mucormycosis in a patient with COVID-19 and leukemia, highlighting the importance of early diagnosis.

## Contribution

The paper presents a clinical case emphasizing the need for increased awareness of pulmonary mucormycosis in hospitalized patients.

## Key findings

- A patient with acute myeloid leukemia and nosocomial COVID-19 developed pulmonary mucormycosis.
- Delayed diagnosis of mucormycosis led to an unfavorable clinical outcome despite antifungal treatment.
- The case highlights the rarity and diagnostic challenges of mucormycosis in non-Indian populations.

## Abstract

Coronavirus disease 2019 (COVID-19) is often linked to a broad range of opportunistic bacterial and fungal infections. The second wave of the COVID-19 pandemic has witnessed an unprecedented surge in mucormycosis cases, predominantly in India, while the disease remained relatively rare in Europe. The authors describe the case of a 62-year-old female patient admitted to the hospital for consolidation therapy with chemotherapy as a part of the treatment protocol for acute myeloid leukemia. During hospitalization, she was diagnosed with nosocomial COVID-19, which later progressed to respiratory deterioration. COVID-19 with bacterial superinfection was presumed, leading to the initiation of empirical antibiotic therapy. A bronchoscopy was performed several days later due to a lack of improvement, revealing an infection by the Rhizopus microsporus complex. Despite antifungal treatment, the patient experienced an unfavorable clinical course and ultimately died. Given the high index of suspicion required to diagnose pulmonary mucormycosis, which can lead to delays in appropriate treatment and increase the burden of disease, the authors are aiming to enhance its awareness.