CASE REPORT: PULMONARY MUCORMYCOSIS AND RHODOCOCCOSIS IN A RENAL TRANSPLANT PATIENT

Abstract

Pulmonary mucormycosis is a rare, rapidly progressive, and often fatal opportunistic fungal infection, especially in immunocompromised patients. Rhodococcus equi, in turn, is an intracellular opportunistic bacterial pathogen that is uncommon in humans, but shows higher prevalence in kidney transplant recipients. We report the case of a 76-year-old male patient, 15 months post-renal transplantation, under immunosuppressive therapy. The clinical course was marked by progressive deterioration of renal function, respiratory failure, need for intensive care support, and administration of multiple antimicrobial agents, including liposomal amphotericin B, vancomycin, and rifampicin. After extensive investigation with computed tomography, fiberoptic bronchoscopy, biopsy, and microbiological cultures, a diagnosis of pulmonary coinfection by mucormycosis and Rhodococcus equi was established. Despite intensive therapeutic measures, the patient progressed to death following clinical deterioration. This case highlights the diagnostic and therapeutic challenges of coinfection with two rare opportunistic pathogens in a transplant recipient, reinforcing the importance of early recognition, prompt management, and aggressive intervention in such scenarios.