Hemoptysis is nonspecific respiratory symptom with variable etiological factors ranging from infections like tuberculosis, pneumonia, fungal infections to malignant lung process. Although Tuberculosis is leading cause of hemoptysis and reason for empirical treatment and delay in diagnosis, computerized tomography and fiberoptic bronchoscopy has made real change towards approach in management of these cases presented with nonspecific symptoms. In this case report, we have documented ‘invasive bronchopulmonary Mucormycosis’ as cause of recurrent hemoptysis and persistent pulmonary opacity on chest radiograph irrespective of best possible conventional treatment including higher antibiotics and blanket cover of anti-tuberculosis treatment for 4 months. We have documented ‘Reverse halo sign’ on chest CT imaging and final diagnosis established with Bronchoscopy guided lung biopsy showing ‘presence of fungal infection causing extensive parenchymal necrosis, angioinvasion and cartilage destruction along with bronchiolar invasion.’ Caution should be taken during biopsy of these hypervascular lesions as propensity to have post-biopsy ‘catastrophic massive hemoptysis.’ We have also documented near total complete resolution of airway and lung lesions to medical management including Amphotericin and Posaconazole.
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