Coinfection of Aspergillus and Cryptococcus in Immunocompromised Host: A Case Report and Review of Literature

Abstract

Management of infections in the immunocompromised patient requires unique considerations that are not typically seen in the immunocompetent. Immunocompromised hosts require a broad set of differential diagnoses when presenting with febrile illness involving a wide variety of microbiology. Moreover, fungal infections are common, and cotreatment of fungal and bacterial infections occurs with regularity. Fungal coinfection, however, is rare. Here, we describe a patient with Aspergillus and recurrent Cryptococcus neoformans coinfection following completion of treatment for pulmonary cryptococcosis.

Successful Management of Mixed Mycosis in HIV-Negative Patients With Different Immune Status: A Case Series Report

“…Pneumocystis jiroveci is also one of the most common pathogens in immunosuppressed hosts (Azoulay et al, 2019). However, the mixed mycoses reported in the literature are mainly mixed infections of Aspergillus and Cryptococcus (Lin et al, 2006;Enoki et al, 2012;Wang et al, 2018;Awari et al, 2020). There have also been reports of Aspergillus and Mucor coinfection in the lung or outside the lungs (Bergantim et al, 2013;Mahadevaiah et al, 2013;Webb et al, 2013).…”

“…The morphological similarity of mold makes pathological diagnosis dependent on experienced technicians. Awari et al and Wang et al reported some cases of mixed mycoses of Aspergillus and Cryptococcus in both immunocompromised and immunocompetent patients (Wang et al, 2018;Awari et al, 2020). Coinfection with Talaromyces marneffei and Cryptococcus neoformans has also been reported in a non-HIV patient (He et al, 2020).…”

“…The most common pulmonary mycoses are Aspergillus, Candida, Cryptococcus species, and Pneumocystis jirovecii (Bongomin et al, 2017;Azoulay et al, 2019;Zhan et al, 2021). Mixed fungal infections have also been reported (Wang et al, 2018;Awari et al, 2020); however, their characteristics have not yet been described in detail, and most are in immunocompromised hosts.…”

Recurrent pulmonary cryptococcosis during chronic HBV infection

“…Other causes contributing to the recurrence of pulmonary cryptococcosis include immunocompromised status, suboptimal therapy, and economic challenges. [ 19 , 20 ]…”

“…Other causes contributing to the recurrence of pulmonary cryptococcosis include immunocompromised status, suboptimal therapy, and economic challenges. [19,20] The precise diagnosis of a disease is paramount to successful treatment. Without an accurate diagnosis, an appropriate treatment cannot be initiated.…”