Dual Disseminated Aspergillosis and Mucormycosis Diagnosed at Autopsy: A Report of Two Cases of Coinfection and a Review of the Literature

Coinfection with invasive aspergillosis and mucormycosis in immunocompromised patients has been reported but is rarely confirmed by tissue histology or autopsy. Serum fungal biomarkers and culture are the primary diagnostic tools but are suboptimal for detecting fungal coinfection. Here, we present the cases of two patients who were immunocompromised due to hematologic malignancy where disseminated aspergillosis and mucormycosis coinfection was only diagnosed upon autopsy despite extensive fungal diagnostic workup, and also review recent literature of such instances of coinfection.

[1]  Soyeoun Lim,et al.  A fatal case report of invasive pulmonary aspergillosis and mucormycosis coinfection in an immunocompetent patient with coronavirus disease 2019 in Korea , 2022, Acute and critical care.

[2]  M. Rajaram,et al.  Pulmonary Aspergillus and Mucor Co-Infection , 2021, Sultan Qaboos University medical journal.

[3]  P. Saldiva,et al.  A single-centre, retrospective study of the incidence of invasive fungal infections during 85 years of autopsy service in Brazil , 2021, Scientific Reports.

[4]  A. Skiada,et al.  Epidemiology and Diagnosis of Mucormycosis: An Update , 2020, Journal of fungi.

[5]  W. Cao,et al.  Fatal Mucormycosis and Aspergillosis in an Atypical Host: What Do We Know about Mixed Invasive Mold Infections? , 2020, Case reports in infectious diseases.

[6]  A. Salmaggi,et al.  Concomitant cerebral aspergillosis and mucormycosis in an immunocompetent woman treated with corticosteroids , 2019, Journal of NeuroVirology.

[7]  M. Murad,et al.  Diagnosis of Fungal Infections: A Systematic Review and Meta-Analysis Supporting ATS Clinical Practice Guideline. , 2019, Annals of the American Thoracic Society.

[8]  A. Bychkov,et al.  Invasive fungal disease in university hospital: a PCR-based study of autopsy cases. , 2015, International journal of clinical and experimental pathology.

[9]  S. Ikehara,et al.  An autopsy case of pulmonary fissure induced by zygomycosis , 2013, International Journal of General Medicine.

[10]  F. Arabía,et al.  Concurrent pulmonary Aspergillus fumigatus and mucor infection in a cardiac transplant recipient: a case report. , 2013, Transplantation proceedings.

[11]  K. Carroll,et al.  Evaluation of nucleic acid sequencing of the D1/D2 region of the large subunit of the 28S rDNA and the internal transcribed spacer region using SmartGene IDNS [corrected] software for identification of filamentous fungi in a clinical laboratory. , 2012, The Journal of molecular diagnostics : JMD.

[12]  C. Rotstein,et al.  Emerging fungal infections in immunocompromised patients , 2011, F1000 medicine reports.

[13]  H. Sugihara,et al.  Lipoid pneumonia with chronic myelomonocytic leukemia. , 2009, Pathology, research and practice.

[14]  M. Sande,et al.  Simultaneous disseminated aspergillosis and zygomycosis in a leukemic patient. , 1979, Southern medical journal.

[15]  E. Maiorano,et al.  Combined mucormycosis and aspergillosis of the oro-sinonasal region in a patient affected by Castleman disease , 2004, Virchows Archiv.