Zygomycosis is an
infection caused by opportunistic fungi of the Zygomycetes class, specifically those from the Mucorales and Entomophthorales orders. It is an uncommon disease, mainly restricted to immunocompromised patients. We report a case of a 73-year-old male patient with a history of
fever (39 degrees C) lasting for 1 day, accompanied by shivering, trembling, and intense
asthenia. The patient was admitted to the intensive care unit with
complex partial seizures, and submitted to orotracheal intubation and
mechanical ventilation under sedation with
midazolam. The electroencephalogram showed evidence of
non-convulsive status epilepticus. There is no fast specific laboratory test that permits confirmation of invasive
fungal disease. Unless the physician suspects this condition, the disease may progress rapidly while the patient is treated with broad-spectrum
antibiotics. Differential diagnosis between fungal and
bacterial infection is often difficult. The clinical presentation is sometimes atypical, and etiological investigation is not always successful. In the present case, the histopathological examination of the biopsy obtained from the right temporal lobe indicated the presence of irregular, round, thick-walled fungi forming papillae and elongated structures of irregular diameter, with no septa, indicative of zygomycete (Basidiobolus). Treatment with
liposomal amphotericin B and
fluconazole was initiated after diagnosis of
meningoencephalitis by zygomycete, with a successful outcome.