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Infección fúngica invasiva mixta por Rhizomucor pusillus y Aspergillus niger en un paciente inmunocompetente

Author:
Pozo-Laderas, Juan Carlos, Pontes-Moreno, Antonio, Robles-Arista, Juan Carlos, Bautista-Rodriguez, M. Dolores, Candau-Alvarez, Alberto, Caro-Cuenca, Maria Teresa, Linares-Sicilia, María José
Source:
Revista iberoamericana de micología 2015 v.32 no.1 pp. 46-50
ISSN:
1130-1406
Subject:
Aspergillus niger, Rhizomucor pusillus, accidents, amphotericin B, aspergillosis, disease course, disease transmission, early diagnosis, fungi, histopathology, males, motorcycles, patients, prognosis, risk factors, surgery
Abstract:
Mucormycosis infections are rare in immunocompetent patients, and very few cases of mucormycosis associated with aspergillosis in non-haematological patients have been reported.A 17-year-old male, immunocompetent and without any previously known risk factors, was admitted to hospital due to a seizure episode 11 days after a motorcycle accident. He had a complicated clinical course as he had a mixed invasive fungal infection with pulmonary involvement due to Aspergillus niger and disseminated mucormycosis due to Rhizomucor pusillus (histopathological and microbiological diagnosis in several non-contiguous sites). He was treated with liposomal amphotericin B for 7 weeks (total cumulative dose>10g) and required several surgical operations. The patient survived and was discharged from ICU after 5 months and multiple complications.Treatment with liposomal amphotericin B and aggressive surgical management achieved the eradication of a mixed invasive fungal infection. However, we emphasise the need to maintain a higher level of clinical suspicion and to perform microbiological techniques for early diagnosis of invasive fungal infections in non-immunocompromised patients, in order to prevent spread of the disease and the poor prognosis associated with it.
Agid:
6041303