An atypical occurrence of Aspergillosis in leukemic patient: Brief description of a clinical case

J Mycol Med. 2018 Dec;28(4):655-658. doi: 10.1016/j.mycmed.2018.10.002. Epub 2018 Oct 23.

Abstract

Herein we describe a 43 year-old Caucasian female patient with acute myeloid leukemia that developed an unconventional form of invasive Aspergillosis. For therapeutic reasons, a Groshong-type central venous catheter was positioned. Monitoring the patient's clinical conditions, positive values for C-reactive protein and galactomannan were correlated with a probably Aspergillosis. Surprisingly no pulmonary evidences were observed. Due to worsening conditions, she was re-hospitalized and a blood culture was performed, whom positivity resulted as the first clinical evidence of Aspergillus fumigatus. Further evidence about species identification was obtained by sequencing the fungal ITS region. We support the clinical value of blood culture as a decisive factor to improve the diagnosis of catheter-related Aspergillosis.

Keywords: Aspergillus fumigatus; Blood culture; CVC; Invasive Aspergillosis; Leukemia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Aspergillosis / blood
  • Aspergillosis / diagnosis*
  • Aspergillosis / drug therapy
  • Aspergillus fumigatus / drug effects
  • Aspergillus fumigatus / genetics
  • Aspergillus fumigatus / growth & development
  • Aspergillus fumigatus / isolation & purification*
  • Blood Culture
  • C-Reactive Protein / analysis
  • Catheter-Related Infections / blood
  • Catheter-Related Infections / diagnosis*
  • Catheter-Related Infections / drug therapy
  • Culture Media
  • DNA, Fungal / genetics
  • DNA, Ribosomal Spacer / genetics
  • Female
  • Galactose / analogs & derivatives
  • Humans
  • Leukemia, Myeloid, Acute / complications*
  • Mannans / analysis
  • Neutropenia / blood
  • Sequence Analysis, DNA
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Culture Media
  • DNA, Fungal
  • DNA, Ribosomal Spacer
  • Mannans
  • galactomannan
  • C-Reactive Protein
  • Galactose