Pulmonary mucormycosis in the setting of chronic obstructive pulmonary disease. A case report and review of the literature.

We describe the first case of pulmonary mucormycosis occurring in a patient with chronic obstructive pulmonary disease (COPD) maintained on chronic low dose oral steroids (10 mg/day). The diagnosis was made by direct histopathological examination and culturing of infected tissue obtained by fiberoptic bronchoscopy. Pulmonary mucormycosis is caused by infection with an opportunistic fungus of the order Mucorales and is an acute, rapidly developing and often fulminant process usually occurring in immunocompromised individuals. Risk factors include neutropenia, hematologic malignancies, uncontrolled diabetes mellitus, skin burns and deferoxamine therapy in dialysis patients. This case illustrates the importance of early suspicion of mucormycosis and immediate diagnostic bronchoscopic examination in cases of rapidly progressing pulmonary infiltrates in COPD patients on low doses of corticosteroids.