Pulmonary mucormycosis in a diabetic patient

We present the ease of a 54 year-old male from Moldavia with diabetes melli tus (type II diabetic), admitted to hospital in January 1999, with ketoacid osis and consolidation of the lower left lobe, The diagnosis of mucormycosi s was confirmed by identification of large, nonseptate hyphae of the order Mucorales. A strain of Rhizopus oryzae (Rhizopus arrhizus) was isolated fro m culture on sabouraud medium. The patient was treated by systemic amphoter icin B, associated with surgical debridement (lobectomy). The treatment wit h amphotericin B was stopped after ten days and the patient was completely asymptomatic and returned to Moldavia. Mucormycoses are rare, and tend to be encountered in individuals with predi sposing factors such as malignant blood disorders (immunocompromised patien ts) or diabetes mellitus. Prognosis is poor, resembling infection with Aspe rgillus, despite aggressive treatment as in the present rase, The gravity o f the condition ran he accounted for by the thrombotic and necrosing nature of the fungal invasion of lung vessels.