Disseminated mucormycosis in an apparently immunocompetent adult- a case report and systematic review of literature

Purpose Mucormycosis is an emerging infectious disease, but still under-recognized, with significant delays in diagnosis and costly treatment. With increasing prevalence in resource-limited settings, it can have devastating consequences. Methods We report a case of disseminated mucormycosis in a patient with no risk factors, with a systematic literature review of disseminated mucormycosis in apparently immunocompetent patients. Result We present the case of a 54-year-old woman from rural India with no prior medical history, who presented with intermittent fever, chronic cough with blood-streaked sputum, and new onset right-sided hemiparesis. Imaging revealed multiple non-cavitary and cavitary lung lesions, and abscesses in the spleen, kidneys, and brain, leading to a suspicion of infective endocarditis or disseminated tuberculosis. Biopsy revealed the presence of aseptate hyphae, and a trehalose peak on MRS further established the diagnosis of disseminated mucormycosis. Aggressive treatment with amphotericin B deoxycholate and posaconazole was initiated, leading to clinical improvement. Conclusion This case emphasizes the importance of considering disseminated mucormycosis in patients with atypical presentations and highlights the need for prompt diagnosis and multidisciplinary management to improve patient outcomes.