An unusual combination of aspergillus- scopulariopsis brumptii coinfection in an immunosuppressed adult male

Aspergillus coinfection with Scopulariopsis brumptii in an immunosuppressed adult male is rare. Patients with Aspergillosis have been described to be coinfected with other organisms, including fungi but the combination with fungi from the Scopulariopsis group has not been so far reported to the best of our knowledge. We report the case of an adult male with monoclonal gammopathy of unknown significance and concurrent COPD, Rheumatoid arthritis on monoclonal antibody therapy and Methotrexate, presenting with recurrent chest infections. Initially, the patient was diagnosed with allergic bronchopulmonary Aspergillosis and treated with antifungal and corticosteroid therapy. During follow up, repeated chest infection was noted despite a range of broad-spectrum antibiotics. Scopulariopsis brumptii was detected on the sputum sample, and specific antifungal treatment was commenced until the full recovery. The patient was on follow up for several years. He is now asymptomatic with no further growth of Aspergillus or Scopulariopsis in his sputum.