A 48 years old Asian male diagnosed with type 2 diabetes mellitus two years back presented to our emergency with complaints of left-sided chest pain, radiating to back and dry cough for 25 days along with a low-grade fever of 99.8  F without any diurnal variation, relieved on medications for 20 days. There was no complaint of shortness of breath, orthopnea, abdominal discomfort, headache, or contact with a tuberculosis patient; however, he had a history of insignificant weight loss and loss of appetite for two months. He was on injectable human insulin (30/70) as 12 units subcutaneously before breakfast and eight units before dinner, and his blood dextrose level was uncontrolled since he reported positive for COVID-19 20 days back. However, he did not need hospitalization, steroids, or oxygen therapy and was managed conservatively in a COVID care center. The characteristic clinical, laboratory, and treatment profile of the patient have been tabulated in Table 1. On presentation, he had a blood pressure of 144/90 mmHg in the right radial artery, a random blood glucose level of 478 mg/dL with positive urinary ketones, a pulse rate of 89/min regular, and oxygen saturation of oxygen 98% under room air. General physical examination was unremarkable, and on chest auscultation, bilateral coarse crepitations were heard more over left interscapular and inframammary areas. An electrocardiograph was done, which showed normal sinus rhythm, and a portable bedside chest radiograph showed bilateral hilar prominence with a possibility of consolidation or a mass lesion (left > right), as shown in Fig. 1. A nasal and oropharyngeal swab for SARS-CoV-2 was taken, which was reported negative. The patient's arterial blood gas showed metabolic acidosis with a pH of 7.32, bicarbonate as 16.8 mEq/L, and normal partial pressure of oxygen and carbon dioxide. On presentation, a provisional diagnosis of newly diagnosed hypertensive with type 2 diabetes mellitus complicated by diabetic ketoacidosis and a lower respiratory tract infection with a query of perihilar mass was made. The patient's blood samples for routine blood parameters were withdrawn along with blood and urine cultures before starting intravenous antibiotics. On admission, blood parameters revealed a hemoglobin of 10.1g/dL, TLC of 13,400 cells/mm3, DLC of 91% neutrophils, 8% lymphocytes, platelets of 4.1 lakhs/mm3, ALT of 50 U/L, AST of 41U/L, LDH of 352 U/L, D-dimer of 497 ng/ml, INR of 1.14, IL-6 of 34 (<7pg/ml) and highly sensitive CRP of 212 mg/L. The patient had a normal renal function test, serum electrolytes, calcium, phosphate, total proteins, and serum albumin levels. As a result, treatment was started with empirical antibiotics as a piperacillin-tazobactam combination with levofloxacin along with strict blood glucose control with an insulin infusion and intravenous fluids. Subsequently, a Contrast-Enhanced Computed Tomography Angiography (CECT- Angio) of the chest was performed, which depicted findings consistent with Pulmonary Mucormycosis and bilateral ground-glass opacities in lower lobes without any evidence of pulmonary artery thrombosis, as shown in Fig. 2, and a normal transthoracic 2D-echo study. On the second day, as the patient recovered from diabetic ketoacidosis, injection liposomal amphotericin B (5-10mg/kg/day) at a dose of 300mg intravenously daily was added to the treatment with the aim of a total dose of 4 g along with strict monitoring of kidney function and serum electrolytes. Later, as the patient continued to have a low-grade fever and dry cough, a bronchoscope-guided bronchial biopsy of the left lower lobe mass was performed. Serial sections of processed tissue demonstrated large areas of necrosis and inflammatory granulation tissue along with aseptate branched fungal hyphae visualized as consistent with mucormycosis. However, an Acid-Fast Bacilli (AFB) stain was negative. As the patient continued to experience low-grade fever, injection vancomycin was added to the treatment because of an elevated serum procalcitonin level, i.e., 1.8 (>2ng/ml for high risk of infection), although his urine microscopy, blood and urine cultures were sterile after 48 hours of incubation. Peripheral smear for malaria antigen, serologies for HIV, hepatitis A, B, C, D, E, dengue, rickettsia, scrub typhus, Leptospira, beta 2 glucans, aspergillosis, galactomannan, and repeated urine routine microscopy, blood and urine cultures reported negative. The patient's blood glucose was taken care of by human (plain) intravenous insulin injections and intravenous fluids, and potassium supplementations. On the seventh day, he developed cough with expectoration, hence sputum for AFB, CBNAAT (Cartridge Based Nucleic Acid Amplification), gram stain, culture sensitivity, and fungal cultures were sent for analysis. On the ninth day, his sputum for AFB was reported positive. CBNAAT showed no rifampicin resistance; hence weight-based anti-tubercular therapy (ATT) (isoniazid 300mg, rifampicin 450 mg, pyrazinamide 1200mg and ethambutol 800mg) along with tablet pyridoxine 20mg were added further to the treatment. The patient started experiencing vomiting and abdominal pain on the eleventh day with deranged liver function tests (AST -127U/L, ALT-98, Total Bilirubin -1.7), hepatic modified ATT (injection streptomycin 0.75g daily, tablet ethambutol 800mg, and tablet levofloxacin 750 mg alternate day) was initiated. However, his abdominal ultrasonography was normal. On the thirteenth day, tab Posaconazole 300mg was also added to treatment. On the sixteenth day, he experienced right nasal congestion with blackish crusting of the nasal septum, a nasal swab for 20% KOH mount was sent, which showed aseptate branched fungal hyphae consisting of mucormycosis, as shown in Fig. 3. A CECT of paranasal sinuses and orbit was done, which showed findings of Sino-nasal mucormycosis, as shown in Fig. 2. Hence, a FESS (Functional Endoscopic Sinus Surgery) guided biopsy and local debridement were done, as shown in Fig- 3. However, on the twentieth day, the patient developed massive hemoptysis and went into hypovolemic shock. Hence, Ryle's tube was inserted, two packed cell volumes of blood were transfused along with inotropes, and the patient was planned for an emergency therapeutic bronchoscopy, however as the patient's GCS (Glasgow Coma Scale) deteriorated patient was electively intubated. Unfortunately, the patient succumbed to his illness on the very next day. Written consent was taken from the patient's relative to reproduce the clinical data.