# Rapidly Fatal Pulmonary Mucormycosis With Pericardial Dissemination: A Case Report and Imaging Insights

## TL;DR

A rare case of rapidly fatal pulmonary mucormycosis with pericardial spread in an immunocompromised patient is reported, emphasizing the need for early detection and intervention.

## Contribution

This case report highlights the exceptional rarity of pericardial dissemination in mucormycosis and underscores the importance of early imaging and clinical awareness.

## Key findings

- Pulmonary mucormycosis rapidly progressed to disseminated disease with pericardial involvement in a chemotherapy patient.
- CT imaging revealed subtle initial findings followed by rapid progression to extensive pulmonary and pericardial disease.
- Despite antifungal treatment, the patient's condition deteriorated rapidly, leading to respiratory failure and death.

## Abstract

Mucormycosis is a rare but aggressive opportunistic fungal infection, predominantly affecting immunocompromised individuals. We report a case of a 59-year-old male with newly diagnosed acute myeloid leukemia undergoing chemotherapy who developed pulmonary mucormycosis, which rapidly progressed to disseminated disease with pericardial involvement, an exceptionally rare occurrence. Initial chest CT imaging showed a subtle perihilar infiltrate, but within days, extensive spread was evident, showing widespread pulmonary consolidation, ground-glass opacities, vascular thrombosis, mediastinal invasion, and pericardial involvement. Bronchoscopy confirmed airway obstruction due to fungal invasion, and biopsy, along with pericardial fluid cultures, revealed Rhizopus microsporus. Despite early antifungal treatment, the patient's condition worsened, making surgery impossible and leading to respiratory failure and death. This case underscores the rapid progression and extensive spread of mucormycosis, highlighting the critical role of early CT imaging and clinical vigilance in high-risk patients. Timely recognition and intervention are essential to improve outcomes through both early medical and possible surgical management in this often-fatal disease.