Pulmonary Mucormycosis in Diabetic Patients: A Case Series From a Tertiary Respiratory Center in Sri Lanka.

Pulmonary mucormycosis is a rare but aggressive fungal infection that primarily affects immunocompromised individuals, especially those with uncontrolled diabetes mellitus. Its non-specific presentation can mimic more common pulmonary conditions, often resulting in delayed diagnosis and treatment. Here, we present a case series of three Sri Lankan patients with type 2 diabetes mellitus who developed pulmonary mucormycosis. Each case demonstrated variable respiratory and constitutional symptoms. Imaging, primarily chest radiography and contrast-enhanced CT, revealed findings such as cavitary lesions and pleural effusions. Diagnosis was confirmed via bronchoscopic or surgical sampling, with fungal stains showing broad, non-septate hyphae characteristic of mucormycosis. Two patients were successfully treated with prolonged intravenous liposomal amphotericin B therapy. One patient, however, rapidly deteriorated and died despite early antifungal initiation. This series underscores the importance of early clinical suspicion and tissue diagnosis in suspected invasive fungal infections among diabetic patients. In resource-limited and endemic settings, timely recognition and intervention remain crucial for improving patient outcomes.