Mucormycosis masquerading as a bronchial mass in an uncontrolled diabetic living at high altitude: a case report

A 60-year-old diabetic woman living at high altitude presented with productive cough, dyspnea, and hypoxemia. Chest CT revealed a soft tissue mass obstructing the right main bronchus with segmental atelectasis. Rigid bronchoscopy showed a smooth, vascular endobronchial lesion causing near-complete airway occlusion. Mechanical debridement restored airway patency. Histopathologic analysis revealed broad, ribbon-like, pauciseptate hyphae with irregular branching, confirming tracheobronchial mucormycosis. The patient was treated with oral isavuconazole, leading to rapid clinical and radiologic improvement. This case highlights the importance of considering invasive fungal infections in diabetic patients with atypical airway lesions, especially in high-altitude settings. Early bronchoscopic intervention and timely antifungal therapy are critical to improving outcomes.