The curious case of aplastic anemia: a fatal triple co-infection with Aspergillus, Mucorales, and Nocardia
Year: 2026
Type: article
Study design: Case Report
Abstract: BACKGROUND: Concurrent opportunistic infections are rare but can lead to life-threatening complications in patients with hematologic disorders. Immunosuppression, particularly severe neutropenia, significantly increases the risk of invasive fungal and bacterial infections. We report a 34-year-old female with chronic hepatitis B initially presented with pancytopenia. Subsequent bone marrow evaluation revealed aplastic anemia, and she subsequently received immunosuppressive therapy. During hospitalization, she developed multiple infectious episodes, including fever, pulmonary nodular lesions, and oral mucosal lesions. PCR assays and histopathology confirmed a rare triple co-infection involving Aspergillus, Mucorales, and Nocardia species. Although multimodal therapy combining antifungal and antibacterial agents and surgical intervention was initiated, persistent neutropenia prevented complete infection resolution. CONCLUSION: Co-infection with Aspergillus, Mucorales, and Nocardia in immunocompromised patients, particularly those with malignancy or receiving corticosteroid therapy, requires early recognition and appropriate therapy to reduce complications and mortality. This case underscores that persistent, profound neutropenia remains an insurmountable barrier to recovery, highlighting that immune reconstitution is as critical as antimicrobial therapy in such scenarios. CLINICAL TRIAL NUMBER: Not applicable.
Source: BMC Infectious Diseases
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7160707457