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Case Reports
. 2020 May 11;12(5):e8050.
doi: 10.7759/cureus.8050.

Aspergillus and Rhizopus Fungal Coinfection in a Patient With Multiple Myeloma

Anum Aqsa  1 , Sami Droubi  1 , Allison Glaser  2
Affiliations
Case Reports

Aspergillus and Rhizopus Fungal Coinfection in a Patient With Multiple Myeloma

Anum Aqsa et al. Cureus. .

Abstract

Opportunistic fungal infections are rare but life-threatening in immunocompromised patients. We discuss a case of an immunocompromised patient with multiple myeloma who presented with shortness of breath, fever, ocular palsy, and hemiplegia. She was found to have influenza A respiratory tract infection complicated by invasive aspergillosis and mucormycosis. Investigation revealed invasive fungal sinusitis and cerebritis. Serum biomarkers, beta-d-glucan, and galactomannan failed to detect fungal disease. We believe that our case is unique as there is limited data available regarding the occurrence of invasive fungal infections after Influenza infections. Furthermore, it highlights the hurdles in the diagnosis of disseminated fungal infection.

Keywords: aspergillus; influenza a; multiple myeloma; rhizopus.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Chest X-ray showing right upper lobe cavitary lesion with a surrounding thick wall
Figure 2
Figure 2. Chest computed tomography with intravenous contrast showed multifocal consolidations with central ground-glass opacities and cavitation, concerning for angioinvasive aspergillosis
Figure 3
Figure 3. Left inferior turbinate showing thick and thin walled septate hyphae (hematoxylin and eosin stain)
Figure 4
Figure 4. Left anterior ethmoid sinus showing cancellous bone and fibrocollagenous tissue with clusters of hyphae (hematoxylin and eosin stain)
Figure 5
Figure 5. Magnetic resonance imaging of the head, orbit, face, and neck with contrast showing sinonasal postsurgical changes with residual diffuse inflammatory changes, and air-fluid levels consistent with the patient's known invasive fungal sinusitis
Figure 6
Figure 6. Magnetic resonance imaging of the head, orbit, face, and neck with contrast showing left frontal lobe wedge-shaped signal abnormality with restricted diffusion and mild marginal enhancement most compatible with cerebritis
Figure 7
Figure 7. Magnetic resonance imaging of the head, orbit, face, and neck with contrast showing optic nerve inflammation/ ischemia.
See this image and copyright information in PMC

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