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

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
Revista iberoamericana de micología 2015 v.32 no.1 pp. 46-50
Aspergillus niger, Rhizomucor pusillus, accidents, amphotericin B, aspergillosis, disease course, disease transmission, early diagnosis, fungi, histopathology, males, motorcycles, patients, prognosis, risk factors, surgery
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.