[Invasive aspergillosis in an immunocompromised patient: clinical and therapeutic considerations]

Infez Med. 2007 Dec;15(4):262-6.
[Article in Italian]

Abstract

The paper describes a case report of a young female with invasive aspergillosis diagnosed after brief treatment with high-dose steroids for autoimmune thrombocytopenia. Early diagnosis of invasive aspergillosis was made with cultures of tracheoaspirates and bronchoalveolar lavage and was confirmed with a transbronchial biopsy. After initial ineffective treatment with liposomal amphotericin B and dissemination from pulmonary to central nervous system involvement, treatment was switched to a combination of voriconazole and caspofungin. After marked clinical and radiological improvement, treatment was switched to the orally administered formulation of voriconazole until the complete disappearance of central nervous system lesion was observed. In the discussion section we underscore the most significant data of the host susceptibility, diagnosis of invasive aspergillosis, complications and treatment. This case ably demonstrates the efficacy of new antifungal agents, even when administered orally, and underscores the variability of host susceptibility to atypical and often unexpected invasive fungal infections.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Aspergillosis / drug therapy
  • Aspergillosis / etiology*
  • Bronchial Fistula / complications
  • Encephalitis / drug therapy
  • Encephalitis / etiology
  • Encephalitis / microbiology
  • Female
  • Fungemia / drug therapy
  • Fungemia / etiology*
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / etiology
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / etiology
  • Neuroaspergillosis / drug therapy
  • Neuroaspergillosis / etiology
  • Pleural Diseases / complications
  • Purpura, Thrombocytopenic, Idiopathic / complications*
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy
  • Respiratory Tract Fistula / complications
  • Stenotrophomonas maltophilia / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents
  • Immunosuppressive Agents