Pulmonary mucormycosis

An 80-year-old man presented with a chief complaint ofInitially it was thought that his right upper limb weakness in the emergency department. Initially, it was thought of asdue to a case of cerebrovascular accident(CVA), sohowever both a CT brain followed by anand a subsequent MRI brain was done and both brain imaging were normal. AThe routine bedsideCXR revealed an unexpected right apical mass and CT demonstrated the typical bird’s nest appearance. Invasion of the spine and chest x-ray showed a well-defined homogenous opacitywall in the region of the brachial plexus satisfactorily explains his right upper zone, followed by the CT chest as described abovelimb weakness. During the investigation, itThe patient was found that the patient had uncontrolled diabetes mellitus(HbA1c-14%).

So in the clinical background ofto have uncontrolled diabetes mellitus (immunocompromised state(HbA1c-14%), the above CT findings are highly suggestive ofa risk factor for mucormycosis that was later confirmed by histopathology report.due to impaired immune function.

Co-authors:

Dr. Neeraj Bharti (MD, Internal Medicine).

Dr. Saket Ballabh (DMRD, DNB, Radiodiagnosis).

Well-defined round homogenous opacity in the right upper zone with an area of relative transradiancy.

There is a well-defined ground glass opacitymass with thick peripheral consolidation (Atollatoll/reversed halo sign) in the apical segment of the right upper lobe and a focalwith cavitation in the area of breakdown in the ground glass opacityrelative central transradiancy (bird's nest sign).

Gas is also seen in the soft tissue of the adjacent chest wall and cervical spinal canal through the intervertebral foramen, likely the cause of the clinical presentation of right upper limb weakness.