1 | INTRODUCTION
Mucormycosis is a rare opportunistic fungal infection compared to
Candida and Aspergillus species and is caused by Mucorales fungi of the
Zygomycetes class.1 Immunocompromised
conditions like Diabetes mellitus, systemic corticosteroid therapy,
neutropenia, hematologic malignancies, stem cell transplant, and
immunocompromised state are the predisposing conditions for
mucormycosis.2,3 Though rhino-cerebral is the
most common presentation however pulmonary mucormycosis is not rare.
Pulmonary mucormycosis results from the inhalation of sporangiospores or
by hematogenous or lymphatic spread.4 Patients with pulmonary mucormycosis usually present with non-specific
symptoms such as cough, breathlessness, chest pain, and fever. Though
early diagnosis is needed to prevent life-threatening complications
however clinical diagnosis is difficult.
Pulmonary mucormycosis is rare in patients with liver cirrhosis. There
are only 19 reported cases of mucormycosis associated with cirrhosis
mainly by HBV and HCV. However, liposomal amphotericin B is the
treatment of choice, and only one report of rhino-cerebral mucormycosis
with cirrhosis was treated effectively with oral
posaconazole.5 All of the patients died
during the treatment. Our case might be the first case of pulmonary
mucormycosis in a patient with decompensated cirrhosis of the liver
treated effectively with oral posaconazole without any side effects and
the patient survives beyond treatment.
Keywords: Decompensated, Posaconazole, Pulmonary Mucormycosis,
Treatment