Aspergillus fumigatus epidural abscess in a renal transplant recipient.
An epidural abscess caused by Aspergillus fumigatus occurred in a recipient of a cadaveric, renal allograft. The patient had persistent back pain and a peripheral neuropathy that involved the lower extremities. Signs of spinal cord compression evolved. No definite portal of entry was found. Diagnosis was made by histologic examination and culture of a biopsy specimen. Therapy, consisting of aggressive surgical debridement, intravenous amphotericin B, and oral flucytosine was unsuccessful in eradicating the organism. At postmortem examination, Aspergillus was identified at the abscess site. To our knowledge, aspergillosis presenting as an epidural abscess in the immunosuppressed, renal transplant recipient has not previously been reported and should be considered in the differential diagnosis of back pain and peripheral neuropathy in such a patient.
D000038:Abscess / Q000382:microbiology*; D001228:Aspergillosis / Q000382:microbiology*; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D001379:Azathioprine / Q000627:therapeutic use; D002102:Cadaver; D006084:Graft Rejection / Q000187:drug effects; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology*; D013116:Spinal Cord / Q000382:microbiology; D013117:Spinal Cord Compression / Q000382:microbiology*; D014184:Transplantation, Homologous
D001379:Azathioprine; D008775:Methylprednisolone