Elderly female with history of uncontrolled DM presenting with DKA and found to have a cavitary lung lesion found to have biopsy proving broad, aseptate, ribbon like hyphae consistent with mucormycosis. Mucormycosis is a invasive fungal infection (common species include Rhizopus, Mucor species); can cause necrosis of host tissue from invading vasculature. The main risk factor for developing mucormycosis: DM with DKA, steroids, underlying malignancy, AIDS and malnutrition. Most commo presentation of Mucor is rhino-orbital-cerebral mucor and pulmonary mucor. Treatment for our patient included lobectomy and Amphtericin IV prior and post surgery.

Differential for cavitary mass:

  • Infection
    • Lung abscess
    • Mycobacteria
    • S. Milleri
    • S. Aureus
    • S. Pyogenes
    • Klebsiella
    • Pseudomonas
    • Tricuspid Endocarditis
    • Lemierre Syndrome
    • Cryptococcus
    • Endemic Mycosis
    • Molds- Mucormycosis
    • Parasites-Paragonimiasis, Entamoeba
  • Malignancy
    • Squamous cell carcinoma
    • Mets from GI/GU tumors
    • Lymphoma, Kaposi Sarcoma
  • Autoimmune
    • GPA
    • RA
  • PE and infarcts

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