Title : Beyond the veil of tuberculosis: Unraveling the fungal mirage- A mucormycosis masquerade
Abstract:
The patient, a 37 year old non-smoker and occasional alcoholic, presented with a three-week history of cough, blood-tinged expectoration, evening fevers, weight loss, and loss of appetite. There was no previous history of Pulmonary Tuberculosis. Notably, the patient had irregular food habits and consumed outside food frequently due to the demands of his delivery job. Physical examination revealed stable vital signs and inspiratory crackles over both infrascapular areas. Imaging studies demonstrated heterogenous opacification in both lower lung zones on chest X-ray, and a CT scan revealed cavitary consolidation in both lower lobes. Routine investigations identified previously undiagnosed diabetes which was uncontrolled. Sputum smear for Acid Fast Bacilli and CBNAAT was negative. Fungal KOH mount revealed fungal elements. Subsequent fungal culture and sensitivity confirmed mucor species growth. The patient was initiated on intravenous liposomal amphotericin B, resulting in slight resolution on repeat CT chest after three weeks. Antifungal therapy was transitioned to oral posaconazole, with a planned follow-up in three weeks
