Neurology, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA.
Neurology, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
BMJ Case Rep. 2023 Aug 27;16(8):e255909. doi: 10.1136/bcr-2023-255909.
Opportunistic fungal infections are a major cause of mortality in immunosuppressed patients, with mucormycosis and aspergillosis as two of the most commonly identified fungal organisms. Coinfection with mucormycosis and aspergillosis is rare, but cases have been reported in literature, most commonly presenting as disseminated invasive fungal infection with cerebrorhino-orbital involvement in an immunocompromised patient. Infections are most commonly caused by direct implantation of spores with localised angioinvasion. Haematogenous spread is rare, with most cases secondary to haematological malignancies or intravenous drug use. Coinfection with mucormycosis and aspergillosis portends a poor prognosis, with a high mortality rate. Thus, prompt recognition and intervention are crucial to prevent poor outcomes. In this unique case report, we describe a case of isolated cerebral mucormycosis and aspergillosis coinfection, not previously reported in literature.
机会性真菌感染是免疫抑制患者死亡的主要原因,其中毛霉病和曲霉病是最常见的两种真菌病原体。毛霉病和曲霉病的合并感染较为罕见,但文献中有报道,最常见的表现为免疫功能低下患者的播散性侵袭性真菌感染,伴有脑-鼻-眶受累。感染最常见的原因是孢子直接植入并局部侵犯血管。血行播散很少见,大多数病例继发于血液系统恶性肿瘤或静脉药物使用。毛霉病和曲霉病合并感染预示着预后不良,死亡率很高。因此,及时识别和干预对于预防不良结局至关重要。在这个独特的病例报告中,我们描述了一例以前文献中未报道的孤立性脑毛霉病和曲霉病合并感染的病例。