Concomitant Mucormycosis and Aspergillosis of Rhinocerebral Region in a Renal Transplant Patient – Air Cooler Being the Culprit

Invasive fungal infections are associated with morbidity and mortality in immunocompromised patients. Rhinocerebral region infections are mainly due to opportunistic fungal pathogens. Although Zygomycosis and Aspergillosis are two major causes of paranasal infections, reports of combined Mucormycosis and Aspergillosis infections of rhinocerebral region are limited. We report a case of fatal, combined rhinocerebral fungal infection in post renal transplant patient, etiology being an air cooler with old wet pads. Prompt diagnosis is challenging and inspite of aggressive management with a combination of surgical and medical therapies, the outcome is poor. Amphotericin B remains the cornerstone in the medical management of mucormycosis and Voriconazole in Aspergillosis, still we are short of drugs to fight with such a devastating organism (Mucor).