Fungemia por complexo Fusarium solani em Coinfecção com Aspergillus terreus após Transplante de Células-Tronco Hematopoéticas Haploidêntico por Anemia Aplásica Grave
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As infecções fúngicas invasivas (IFIs) representam importante causa de morbidade e mortalidade em pacientes submetidos a transplante de células-tronco hematopoéticas (TCTH), especialmente na vigência de imunossupressão profunda e prolongada. Entre os agentes etiológicos emergentes, destacam-se os fungos filamentosos, notadamente Aspergillus spp. e Fusarium spp., cuja coinfecção, embora rara, configura expressivo desafio diagnóstico e terapêutico. Relata-se um caso inédito de coinfecção por Aspergillus terreus e complexo Fusarium solani em paciente com anemia aplásica grave submetido a TCTH haploidêntico. O paciente evoluiu com quadro clínico compatível com infecção fúngica disseminada, caracterizada por fungemia por Fusarium e lesões cutâneas necróticas, apesar da terapia antifúngica combinada. A falência da enxertia hematopoética e a neutropenia prolongada configuraram os principais fatores determinantes do desfecho desfavorável. Este caso ilustra a complexidade e gravidade das coinfecções fúngicas invasivas em hospedeiros imunocomprometidos, enfatizando a necessidade de vigilância microbiológica rigorosa, diagnóstico precoce e novas abordagens terapêuticas integradas associadas à recuperação imunológica efetiva.
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