Primary renal aspergillosis: extremely uncommon presentation in patients treated with bone marrow transplantation.
Invasive aspergillosis affects 3 to 11% of BMT patients with a high mortality rate (60 to 95%). Extra-pulmonary disease is an unusual event, and primary renal aspergillosis is extremely uncommon. A patient with CML treated with BMT, who developed primary renal and subsequently hepatic aspergillosis, is described. Dysfunction of the mucosal barrier secondary to conditioning therapy, was a possible portal of entry for the fungus. Fine needle aspiration was very useful, as is direct microscopic examination of the urine, for diagnosis of the fungal infection. Surgical drainage of the abscess followed by antifungal therapy is the treatment of choice. Unconducive situations, such as refractory thrombocytopenia, are associated with the worst outcome in these patients.
de Medeiros
C R
CR
Bone Marrow Transplantation Service, Hospital de Clínicas, UFPR, Curitiba, Paraná, Brazil.
Dantas da Cunha
A
A
Pasquini
R
R
Arns da Cunha
C
C
D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D001230:Aspergillus / Q000187:drug effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002066:Busulfan / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D017809:Fatal Outcome; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000382:microbiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003520:Cyclophosphamide; D002066:Busulfan