{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T13:04:43Z","timestamp":1767791083745,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Cutaneous aspergillosis caused by Aspergillus flavus is rare and coinfection with Klebsiella pneumoniae was reported only in pulmonary disease. Case Presentation: We describe a 57-year-old woman with no prior comorbidities who developed septic shock requiring intensive care, broad-spectrum antibiotics, corticosteroids, and renal replacement therapy. Six days after discharge, she was readmitted with fever, leukopenia, thrombocytopenia, cavitary lung lesions, and multiple erythematous nodules on the limbs and mammary regions. Bronchial aspirate cultures detected K. pneumoniae, while progressive cutaneous lesions required surgical debridement. Histopathology revealed angioinvasive septate hyphae, and MALDI-TOF identified A. flavus. The K. pneumoniae strain was extensively drug resistant; A. flavus was susceptible only to azoles. Despite targeted therapy, lesions progressed requiring bilateral mastectomy. Conclusions: This case illustrates a previously unreported scenario in which secondary immunosuppression after severe sepsis led to concurrent cutaneous A. flavus infection and extensively drug-resistant (XDR) K. pneumoniae. Early recognition of mixed fungal\u2013bacterial infections is essential for appropriate management.<\/jats:p>","DOI":"10.3390\/diagnostics16020183","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:26:56Z","timestamp":1767774416000},"page":"183","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First Case of Cutaneous Coinfection with Aspergillus flavus and Klebsiella pneumoniae: Case Report and Literature Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2512-2691","authenticated-orcid":false,"given":"Simona Maria","family":"Borta","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University of Arad, Bulevardul Revolu\u021biei 94, 310025 Arad, Romania"},{"name":"Arad County Clinical Emergency Clinical Hospital, Str. Andr\u00e9nyi K\u00e1roly Nr. 2-4, 310037 Arad, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsolt","family":"Gyori","sequence":"additional","affiliation":[{"name":"Arad County Clinical Emergency Clinical Hospital, Str. Andr\u00e9nyi K\u00e1roly Nr. 2-4, 310037 Arad, Romania"},{"name":"Department of Microsurgery and Reconstructive Surgery, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University of Arad, Bulevardul Revolu\u021biei 94, 310025 Arad, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosmin Catalin","family":"Bacean","sequence":"additional","affiliation":[{"name":"Arad County Clinical Emergency Clinical Hospital, Str. Andr\u00e9nyi K\u00e1roly Nr. 2-4, 310037 Arad, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1192-1452","authenticated-orcid":false,"given":"Romana Olivia","family":"Popetiu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University of Arad, Bulevardul Revolu\u021biei 94, 310025 Arad, Romania"},{"name":"Arad County Clinical Emergency Clinical Hospital, Str. Andr\u00e9nyi K\u00e1roly Nr. 2-4, 310037 Arad, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Petrine","sequence":"additional","affiliation":[{"name":"Arad County Clinical Emergency Clinical Hospital, Str. Andr\u00e9nyi K\u00e1roly Nr. 2-4, 310037 Arad, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melani","family":"Zarici","sequence":"additional","affiliation":[{"name":"\u201cPius Branzei\u201d Timisoara County Clinical Emergency Hospital, Str. Bulevardul Liviu Rebreanu, Nr. 156, 300723 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lavinia","family":"Palaghian","sequence":"additional","affiliation":[{"name":"\u201cVictor Popescu\u201d Timisoara Military Clinical Emergency Hospital, Str. Gheorghe Lazar, Nr. 7, 300723 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4374-4248","authenticated-orcid":false,"given":"Adrian Silviu","family":"Crisan","sequence":"additional","affiliation":[{"name":"Arad County Clinical Emergency Clinical Hospital, Str. Andr\u00e9nyi K\u00e1roly Nr. 2-4, 310037 Arad, Romania"},{"name":"Department of Critical Care and Emergency Medicine, \u201cVasile Goldi\u0219\u201d Western University of Arad, Bulevardul Revolu\u021biei 94, 310025 Arad, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12929-023-00926-2","article-title":"Diagnosis of invasive fungal infections: Challenges and recent developments","volume":"30","author":"Fang","year":"2023","journal-title":"J. Biomed. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S261","DOI":"10.1080\/13693780802247702","article-title":"Differences in pathogenicity and clinical syndromes due to Aspergillus fumigatus and Aspergillus flavus","volume":"47","author":"Pasqualotto","year":"2009","journal-title":"Med. 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