Coinfection of pulmonary tuberculosis and mucormycosis in a patient with poor controlled diabetes mellitus: A case report

Coinfection of pulmonary mucormycosis and tuberculosis is a rare and challenging condition, particularly in immunocompromised patients. We present the case of a 60-year-old woman with poorly controlled diabetes mellitus who developed dysphonia, persistent cough, and expectoration. Imaging studies revealed a cavitary lesion and a mass in the left lung, along with stenosis of the left main bronchus. A bronchoscopy confirmed the presence of a bronchomediastinal fistula with pus discharge. Polymerase chain reaction testing of bronchial secretions revealed a co-infection of tuberculosis and mucormycosis. The patient was initiated on appropriate treatment for both infections, and her symptoms improved without disease progression. Concomitant pulmonary mucormycosis and tuberculosis pose significant diagnostic challenges due to overlapping clinical and radiological features. Early recognition and a multidisciplinary approach involving infectious disease specialists, pulmonologists, radiologists, and surgeons are crucial for optimal management. The prognosis of this coinfection is poor, emphasizing the importance of timely diagnosis and treatment. To improve outcomes, comprehensive screening and early detection of coinfections in high-risk patients, such as those with uncontrolled diabetes, are essential. Future advancements in diagnostic tools may facilitate prompt and accurate diagnosis. Clinicians should maintain a high index of suspicion and employ appropriate diagnostic techniques to ensure early identification and effective management of these complex infections.