Pulmonary mucormycosis in a renal transplant recipient with poor glycaemic control: A tropical case with literature review

Background Mucormycosis is an aggressive, angioinvasive fungal infection increasingly reported among immunocompromised individuals, particularly those with diabetes and solid organ transplants. Pulmonary involvement carries a high mortality rate, especially when the diagnosis is delayed. Case Presentation A 60-year-old man with a history of renal transplantation one year earlier for end-stage renal disease and poorly controlled type 2 diabetes mellitus presented with seven days of fever, worsening cough, pleuritic chest pain, and dyspnea following recent hospitalization. Initial high resolution computed tomography of the chest showed bilateral lower-lobe cavitating consolidations. Subsequent fiber-optic bronchoscopy (FOB) revealed a friable, spongiform endobronchial mass completely occluding the left mainstem bronchus and extending into the segmental bronchi of the upper, middle, and lower lobes. Complete endobronchial debulking was successfully achieved using advanced bronchoscopy-guided interventions, including cryoablation, argon plasma coagulation, and snare-forceps excision, thereby avoiding high-risk surgical intervention. Histopathological examination confirmed invasive pulmonary mucormycosis. Subsequent treatment with liposomal amphotericin B and oral posaconazole for residual parenchymal disease resulted in significant clinical and radiological improvement. Conclusion This case highlights the potential role of advanced bronchoscopy-guided interventions as both diagnostic and therapeutic adjuncts in pulmonary mucormycosis with endobronchial involvement, particularly in high-risk patients for whom conventional surgical management is not feasible.