Ante-mortem diagnosis of localized invasive esophageal aspergillosis in a patient with acute myeloid leukemia.
Opportunistic infection with invasive aspergillosis (IA) is increasingly frequent in immunocompromised patients, particularly in those with hematological malignancies. In this setting, IA typically involves the lung, with extra-pulmonary involvement usually occurring in the setting of disseminated infection. We report a case of localized gastrointestinal IA complicating induction chemotherapy for acute myeloid leukemia (AML). Oral voriconazole was successful as primary treatment, with no evidence of progressive infection despite further myelosuppressive chemotherapy. A review of the literature suggests that although localized gastrointestinal IA is rare, involvement of the gastrointestinal tract is not uncommon in disseminated infection. Thus, in patients with hematological malignancies who develop significant gastrointestinal symptoms, we recommend that endoscopic investigations and biopsies are performed to exclude IA as a potential cause.
Chionh
Fiona
F
Department of Haematology and Medical Oncology, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia.
Herbert
Kirsten E
KE
Seymour
John F
JF
Prince
H Miles
HM
Wolf
Max
M
Zimet
Alan
A
Tam
Constantine
C
Kennedy
Glen A
GA
D000208:Acute Disease; D000368:Aged; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D004935:Esophageal Diseases / Q000150:complications* / Q000175:diagnosis*; D005773:Gastroscopy; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications* / Q000628:therapy; D008297:Male; D009361:Neoplasm Invasiveness; D009894:Opportunistic Infections / Q000150:complications*; D012074:Remission Induction