Invasive Pulmonary Mucormycosis Due to Rhizopus oryzae in a Patient With Uncontrolled Diabetes

A man in his 60s with poorly controlled type 2 diabetes mellitus presented with subacute shortness of breath and hemoptysis. Imaging demonstrated extensive bilobar cavitary destruction of the left lung with pleural extension. Bronchoalveolar lavage cultures isolated Rhizopus oryzae, and intravenous liposomal amphotericin B was commenced. Definitive surgical management via pneumonectomy was precluded by the patient's severe cardiomyopathy and limited pulmonary reserve. The patient was discharged on prolonged antifungal therapy but was readmitted within one week with recurrent hemoptysis. Bronchial artery embolization was deemed too high risk. He subsequently developed catastrophic hemorrhage and died. This case highlights the rapid clinical progression of diabetic pulmonary mucormycosis and underscores the poor prognosis when patient comorbidities preclude surgical source control.