LAUSR

Author: Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK testing for TB was negative. Histology and cultures showed pauci-septate branching non-pigmented fungal hyphae and Apophysomyces variabilis. A diagnosis of central nervous system (CNS) mucormycosis was made; isavuconazole with IV liposomal amphotericin was commenced. Despite 4 weeks of treatment, deterioration continued, leading to his death. Mucormycosis is an opportunistic fungal infection. Prevalence is low in developed countries compared with developing nations, like India, where prevalence is 70 times higher. Common causes for CNS involvement are intravenous drug use (62%) and uncontrolled diabetes (43%). Mortality has been reported as 46%, with 68% in disseminated infections. Histology and culture are essential for diagnosis. Treatment is liposomal amphotericin and surgical debridement with the duration guided by radiological and clinical response. The need to consider fungal infections in immunocompromised patients with worsening symptoms despite broad spectrum antibiotics is highlighted. Prompt treatment is paramount due to high mortality.