A 69-year-old man with lymphocytic leukemia presented with fever, a pericardial friction rub, widening of the mediastinum, and left pleural effusion. Atrial fibrillation, refractory hypotension and acute paraplegia punctuated his hospital course. Invasion of the mediastinum, myocardium, mediastinal, coronary and spinal arteries with mucormycosis was present at post-mortem examination.