Title : Suspected pulmonary tuberculosis turned out to be a invasive mucor mycosis
Abstract:
A 35 year old male admitted with complaints of cough with expectoration for 3 weeks, which is mucoid in consistency, sometimes blood tinged, history of evening rise of temperature for last 14 days, history of loss of weight and loss of appetite present, no history of pervious similar complaints and no previous history of Pulmonary Tuberculosis, no other associated comorbidities, non smoker, Alcoholic. Patient was taking outside food for last 6 months because of his delivery job. On examination patient was stable , Inspiratory crakles heard over both infrascapular areas, chest Xray shows – heterogenous opacification both lower zones, CT Chest shows cavitary consolidation in both lower lobes. On routine examination pt was diagnosed to have diabetes which was uncontrolled, sputum AFB smear was negative, CBNAAT also MTB not detected, bacterial c/s no growth, but Fungal elements were seen in Fungal KOH mount. Patient started on Antifungal Inj.Liposomal Amphotericin B 300mg od, on due coarse of time Fungal culture & sensitivity positive for mucor species growth antifungal continued for 3 weeks , repeat CT chest shows slight resolution in that lesion and patient was adviced to continue oral Antifungal posaconazole, Review after 3 weeks.
