Disseminated Mucormycosis and monoclonal gammopathy in a young sarcoidosis patient following COVID-19: A rare case report.

Disseminated mucormycosis is a rare but highly fatal invasive fungal infection, typically occurring in immunocompromised hosts. We report a case of culture- and PCR-confirmed disseminated mucormycosis in a previously healthy 25-year-old male who developed sarcoidosis and IgG-kappa monoclonal gammopathy of undetermined significance after contracting COVID-19. The patient presented with progressive respiratory symptoms and later developed multi-organ involvement, including the lungs, brain, kidneys, eyes, heart, lymph nodes, prostate, and vocal cords. Histopathological examination of renal biopsy and bronchoalveolar lavage specimens demonstrated broad, ribbon-like aseptate hyphae with right-angle branching, consistent with Mucorales. Fungal cultures yielded characteristic colonies, and Mucorales-specific PCR confirmed the diagnosis. Despite treatment with amphotericin B and adjunctive antifungal therapy, the patient developed septic shock, multiorgan failure and passed away. This rare case highlights the diagnostic and therapeutic challenges encountered when treating patients with concurrent granulomatous disease, opportunistic fungal infection, and underlying hematological abnormalities. It also underlines the importance of early detection, a high index of suspicion and initiation of prompt aggressive treatment in these patients.