Pulmonary Aspergillus and Mucor co-infection : a report of two cases

Co-infections or consecutive infections of mucormycosis and aspergillosis are very rare. Additionally, distinguishing between these two infections is also difficult as both these conditions have similar clinical features. We report two similar cases from Tamilnadu, who presented to a tertiary care c...

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Bibliographic Details
Published inSultan Qaboos University medical journal Vol. 21; no. 3; pp. 495 - 498
Main Authors Sneha, L., Ravindra, Chari M., Rajaram, Manju, Madhusmita, M., ChToi, Pampa
Format Journal Article
LanguageEnglish
Published Muscat, Oman Sultan Qaboos University, College of Medicine and Health Sciences 01.08.2021
Sultan Qaboos University
Sultan Qaboos University Medical Journal, College of Medicine & Health Sciences
Subjects
Antifungal agents
Biopsy
Blood
Case Report
Diabetes
Fungal infections
Fungi
Histopathology
Infectious diseases
Lungs
Patients
Pneumonia
Serology
Sinuses
Tomography
Tuberculosis
India
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Summary:Co-infections or consecutive infections of mucormycosis and aspergillosis are very rare. Additionally, distinguishing between these two infections is also difficult as both these conditions have similar clinical features. We report two similar cases from Tamilnadu, who presented to a tertiary care centre in Puducherry, India in 2017 (first case) and 2019 (second case). The first case was a 70-year-old, non-diabetic male patient who presented with haemoptysis with a prior history of pulmonary tuberculosis. Computed tomography bronchial angiography revealed an air-crescent sign and the histopathological examination showed a fungal ball (aspergillus and mucor) in the right upper lobe and foci of fungal infection in the middle lobe. The second case was a 65-year-old diabetic male patient who presented with blackish expectoration and haemoptysis. A high-resolution computed tomography scan showed a reverse-halo sign in the right upper lobe. The results of the bronchoscopy-guided biopsy were consistent with a diagnosis of mixed mucormycosis and aspergillosis with angioinvasion. Both patients responded to amphotericin B with surgical excision of the affected lobe in the first case. A high degree of clinical suspicion, early surgical intervention and antifungal therapy are essential in the treatment of this rare co-infection.
ISSN:2075-051X
2075-0528
2075-0528
DOI:10.18295/squmj.8.2021.126