Invasive pulmonary aspergillosis in a puerperant with drug-induced agranulocytosis.
Invasive pulmonary aspergillosis (IPA) is an acute infection of Aspergillus species to the lungs. It generally occurs in immunocompromised hosts, especially with neutropenia. We report a 30-year-old puerperant, who developed IPA from agranulocytosis. She had been treated for threatened labor with ritodrine and cefepime, one of which induced agranulocytosis. After vaginal delivery of twins, pneumonia emerged in the right lower lobe. She was diagnosed to have IPA according to the halo sign on computed tomography (CT) and positive circulating antibody against Aspergillus, and was treated successfully with oral itraconazole followed by surgical resection. It is important to note that IPA might arise in otherwise immunocompetent hosts when neutropenia is long-standing.
Aoki
F
F
Department of Medicine, Social Insurance Gunma Chuo General Hospital, Maebashi.
Sando
Y
Y
Tajima
S
S
Imai
K
K
Hosono
T
T
Maeno
T
T
Suga
T
T
Sugano
J
J
Shitara
Y
Y
Kurabayashi
M
M
D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced* / Q000150:complications* / Q000276:immunology; D001228:Aspergillosis / Q000175:diagnosis* / Q000276:immunology; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D000077723:Cefepime; D002511:Cephalosporins / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000276:immunology; D011247:Pregnancy; D011645:Puerperal Infection / Q000175:diagnosis* / Q000276:immunology; D012312:Ritodrine / Q000009:adverse effects*; D012720:Severity of Illness Index; D015149:Tocolytic Agents / Q000009:adverse effects*
D002511:Cephalosporins; D015149:Tocolytic Agents; D000077723:Cefepime; D012312:Ritodrine