Cavitary necrotizing pneumonia with bacterial-fungal coinfection in a patient with diabetic ketoacidosis

Abstract Necrotizing cavitary pneumonia with bacterial-fungal coinfection in diabetic ketoacidosis (DKA) is a serious and potentially life-threatening condition. Patients with diabetes, especially those in DKA, are particularly vulnerable to severe infections due to impaired immune function, hyperglycemia, and the metabolic derangements of DKA. Here, we present a young patient with DKA, who presented with high fever, dyspnea, and recurrent hemoptysis, who was diagnosed with dual bacterial-fungal infection and had a fatal outcome. The bacterial-fungal coinfection indicates a complex pathogen landscape requiring broad and aggressive antimicrobial therapy. Early recognition, aggressive DKA management, prompt initiation of broad-spectrum antibacterial and antifungal therapy, and consideration of surgical intervention are crucial for improving patient outcomes. Mortality rates in necrotizing cavitary pneumonia due to dual bacterial and fungal etiology in an immunosuppressed patient with recurrent massive haemoptysis can be alarmingly high.