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Mucormycosis — SCE Infectious Diseases MCQ

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HardFungal InfectionsMucormycosisSCE Infectious Diseases

A neutropenic patient receiving posaconazole prophylaxis develops breakthrough fever and a reversed-halo pulmonary lesion. Galactomannan and beta-D-glucan are negative. Which infection is most concerning?

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Correct answer: D — Breakthrough pulmonary mucormycosis during mould-active azole prophylaxis

The best answer is “Breakthrough pulmonary mucormycosis during mould-active azole prophylaxis”. Mucorales can break through mould-active azole prophylaxis, the reversed-halo sign is suggestive in the right host, and common fungal biomarkers are often negative. Mucormycosis diagnosis requires urgent tissue assessment; management combines reversal of predisposing factors, a liposomal amphotericin formulation plus surgical debridement where feasible.

Reference: Global guideline for the diagnosis and management of mucormycosis: https://pmc.ncbi.nlm.nih.gov/articles/PMC8559573/