Rhinocerebral zygomycosis with pulmonary aspergillosis in a non-HIV-infected patient: an unusual case report from India.
Zygomycosis and aspergillosis are two serious opportunistic fungal infections that are commonly seen in immunocompromised patients. Since both these fungi invade vessels of the arterial system, an early and rapid diagnosis by direct examination of KOH mounts of the relevant clinical sample can confirm the diagnosis. Here, we present an unusual case of a diabetic patient who presented with nasal blockade and bleeding for 2 months, along with occasional haemoptysis for 15 days. On investigation, the patient was diagnosed with a case of rhinocerebral zygomycosis and was treated with amphotericin B (1 mg kg(-1) day(-1)), which was subsequently replaced with liposomal amphotericin B (2 mg kg(-1) day(-1)). However, the patient did not completely respond to therapy as haemoptysis continued. Further investigations revealed the presence of Aspergillus flavus in respiratory specimens. Thus, a final diagnosis of rhinocerebral zygomycosis with pulmonary aspergillosis in a non-HIV-infected patient was made, but due to infection of two vital sites by these fungi, the patient could not be saved.
Malhotra
Shalini
S
Department of Microbiology, Dr Ram Manohar Lohia Hospital, New Delhi, India.
Duggal
Shalini
S
Department of Microbiology, Dr Ram Manohar Lohia Hospital, New Delhi, India.
Bhatia
Nirmaljeet Kaur
NK
Department of Microbiology, Dr Ram Manohar Lohia Hospital, New Delhi, India.
Sharma
Nishi
N
Department of Otorhinolaryngology, Dr Ram Manohar Lohia Hospital, New Delhi, India.
Hans
Charoo
C
Department of Microbiology, Dr Ram Manohar Lohia Hospital, New Delhi, India.
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2; D005260:Female; D015658:HIV Infections; D006801:Humans; D007194:India; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000150:complications / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D055732:Pulmonary Aspergillosis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D020096:Zygomycosis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*
D000935:Antifungal Agents; D000666:Amphotericin B