Pulmonary mucormycosis: surgical management at a national health institute in México

Background: Pulmonary mucormycosis is an opportunistic and potentially fatal fungal infection affecting immunocompromised individuals. Its incidence has risen, ranking as the third most common form after rhino-orbito-cerebral and cutaneous mucormycosis. Its rapid progression complicates early diagnosis and worsens prognosis. Key risk factors include hematologic malignancies, solid organ transplantation, diabetes mellitus, and corticosteroid use during COVID-19. Objective: To describe the clinical, radiological, and therapeutic features of pulmonary mucormycosis cases at a national referral center and identify factors associated with disease progression and mortality. Methods: A retrospective study was conducted at the National Institute of Respiratory Diseases of Mexico, analyzing nine confirmed cases between 2022 and 2024. Treatment included antifungal agents such as amphotericin B, isavuconazole in selected cases, and surgical interventions. Results: Computed tomography revealed involvement of multiple pulmonary lobes. The 90-day mortality rate following combined therapy was 44.4%. Diabetes mellitus and biomass exposure were common and identified as aggravating factors. Conclusions: This study highlights the importance of a multidisciplinary approach and timely diagnosis in improving clinical outcomes in pulmonary mucormycosis. The high prevalence of comorbidities and environmental exposures underscores the complexity of management. This case series provides relevant information to optimize diagnostic and therapeutic strategies, ultimately improving prognosis in this highly lethal infection.