Coinfection with cryptococcus and aspergillus in an immunocompetent adult: A case report
Qi Wang1, Zhaoyong Wang2, Yuqiu Hao1
1Department of Respiratory and Critical Care Medicine.
Rationale:
Aspergillus and Cryptococcus exposure can cause serious secondary infections in human lungs, especially in immunocompromised patients or in conjunction with a chronic disease caused by low disease resistance. Primary invasive fungal infections are clinically rare; therefore, coexistence of 2 fungi at an infection site is uncommon. This paper reports a case of healthy male who was diagnosed with both Cryptococcus neoformans and Aspergillus infections.
Patient Concerns:
A healthy 33-year-old male office worker was admitted to the Second Hospital of Jilin University for hemoptysis. A chest computed tomography (CT) scan showed a cavity, which was formed by the thick dorsal wall of the lower left lobe with an irregular inner wall and burr changes around the lesion.
Intervention:
After 1.0 week of antibiotic and antituberculosis treatment, the hemoptysis symptoms remained. A resection of the left lower lobe was performed.
Diagnoses:
The postoperative pathological reports indicated the presence of both Aspergillus and Cryptococcus. The 2 fungal lesions were separate but within the same location.
Outcomes:
After treatment, the patient no longer had hemoptysis.
Lessons:
The current study indicated that fungi can infect not only immunocompromised patients but also healthy people, and that there can be 2 separate fungal infections at the same infection site.
Insights
This case study highlights that healthy individuals can develop serious lung infections from Aspergillus and Cryptococcus co-infections. Early diagnosis and surgical intervention were key to resolving hemoptysis in this patient.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonology
Background:
- Aspergillus and Cryptococcus infections typically affect immunocompromised individuals or those with chronic diseases.
- Co-infection with multiple fungal pathogens at a single site is clinically rare.
- Primary invasive fungal infections are uncommon.
Observation:
- A healthy 33-year-old male presented with hemoptysis.
- Chest CT revealed a cavitary lesion in the left lower lobe.
- Initial antibiotic and antituberculosis treatment failed to resolve symptoms.
Findings:
- Surgical resection of the affected lung lobe was performed.
- Postoperative pathology confirmed separate lesions of both Aspergillus and Cryptococcus neoformans.
- The patient's hemoptysis resolved after treatment.
Implications:
- Fungal lung infections, including co-infections, can occur in seemingly healthy individuals.
- This case underscores the importance of considering fungal etiologies even in non-immunocompromised patients.
- Prompt diagnosis and appropriate intervention, including surgery, can lead to favorable outcomes for complex fungal infections.
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