Pneumorrhachis due to invasive mucormycosis in a renal transplant recipient

Pneumorrhachis is often associated with trauma or postsurgical changes; few cases are reported as a result of infectious causes in adults. Here, we describe a 61-year-old male with a history of renal transplantation and diabetes with weight loss and imaging findings suggestive of atypical infection. He progressively deteriorated, was intubated, and was found to have new weakness. Imaging revealed necrotizing pneumonia with pneumospinal fistula through the spinal foramen, pneumorrhachis, and cord infarction, which ultimately proved fatal and were found to be due to Rhizopus spp on autopsy.