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• W2034771430 abstract "Las infecciones mixtas de origen fúngico, aunque poco valoradas, puede que sean más habituales de lo referido en la literatura médica. Dichas infecciones tienen, en general, un peor pronóstico para el paciente. Presentar un caso clínico inusual en un paciente de 61 años, diabético descompensado, que en 2001 debutó con zigomicosis rinoorbitosinusal. Se trató con amplia resección quirúrgica y anfotericina B liposomal, mejorando su cuadro clínico. Años después presentó un cuadro de similares características, realizándose otra vez el diagnóstico de zigomicosis rinoorbitocerebral. En ambas ocasiones se realizó un estudio histopatológico de las lesiones de senos, y se colorearon con tinción de hematoxilina y eosina, Giemsa, ácido periódico de Schiff y plata metenamina modificada de Grocott, además de cultivos específicos para hongos. En la última recidiva los estudios histopatológicos mostraron una infección mixta de bacterias, actinomicetos y hongos con cuatro morfologías diferentes. A pesar del rápido diagnóstico, el paciente falleció por diseminación fúngica al sistema nervioso central. La infección múltiple por hongos es muy infrecuente, pero dado el gran aumento del número de pacientes con alteraciones inmunitarias puede acontecer con mayor frecuencia. Alertamos de esta posibilidad y, si se detecta, debe ser valorada como una micosis más agresiva y de peor pronóstico. Mixed fungal infections although undervalued, are more common than mentioned in the scientific literature. These infections have a poor prognosis for the patient. We present an unusual case of a 61-year-old diabetic male who had a rhino-orbito-sinusal zygomycosis in 2001. After surgical debridement of the infected parts, along with antifungal therapy with liposomal amphotericin B, the patient started improving. Several years later the patient was hospitalized due to a similar problem and was diagnosed of rhino-orbito-cerebral zygomycosis. In both episodes, a histopathological examination and cultures were performed on the sinus lesions. Tissue sections were stained with haematoxylin and eosin, Giemsa, periodic acid-Schiff (PAS) and Grocott's methenamine silver, and cultures specific for fungi were performed. The histopathology studies revealed the presence of bacteria, actinomyces and a mixed infection by at least four different fungi, all of them well differentiated by their morphology. Despite the rapid diagnosis the patient died due to spreading to the central nervous system. Mixed infections by fungi are rare, but due to the high incidence of immunodeficiencies they could occur more often than reported. We would like to alert on the possibility of acquired mixed infection by fungi which have shown to be high aggressive and have a worse prognostic in patients with underlying diseases." @default.
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• W2034771430 date "2010-07-01" @default.
• W2034771430 modified "2023-10-16" @default.
• W2034771430 title "Infección múltiple fúngica en un paciente diabético" @default.
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• W2034771430 doi "https://doi.org/10.1016/j.riam.2010.04.002" @default.
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