title: [Pulmonary aspergillosis in a non-immunocompromised critically ill patient].
abstract: BACKGROUND
  In non-immunocompromised patients admitted to intensive care departments or units (ICU), it is difficult to establish a definitive diagnosis of pulmonary aspergillosis because the signs and symptoms of this infectious disease are non-specific, and serological techniques are not very specific as well. For this reason, a diagnosis of possible pulmonary aspergillosis is initially established, and the starting of the treatment is controversial.
  
  
  METHODS
  An immunocompetent subject had a work-related accident after a fall, which resulted in multiple injuries (head, thorax, lower extremities). The patient required mechanical ventilation since admission. On the second week of ICU admission, he showed a clinical presentation of respiratory infection with fever, purulent secretions, bilateral pulmonary infiltrates and repeated isolation of Mucor and Aspergillus fumigatus in bronchial secretions and pharyngeal swabs. The patient was treated with amphotericin B lipid complex and voriconazole with an excellent clinical and radiological outcome.
  
  
  CONCLUSIONS
  Combined treatment of antifungal agents, in this case amphotericin B lipid complex and voriconazole, is a therapeutic possibility to be considered in patients who failed to respond to initial antifungal monotherapy.
authors.affiliation: Servicio de Medicina Intensiva, Hospital del Mar, Parc de Salut Mar, Barcelona, España. Falvarez@parcdesalutmar.cat
authors.forename: Francisco
authors.initials: F
authors.lastname: Álvarez-Lerma
authors.forename: Ana
authors.initials: A
authors.lastname: Rey-Pérez
mesh_terms: D000328:Adult; D016638:Critical Illness; D006801:Humans; D007121:Immunocompetence; D008297:Male; D055732:Pulmonary Aspergillosis / Q000175:diagnosis*