Aspergillus thyroiditis in a living donor liver transplant recipient.
Aspergillosis is increasingly recognized as an important nosocomial pathogen in immunocompromised patients. Infection is difficult to diagnose and typically has a fatal outcome. We describe a liver transplant patient with fulminant hepatic failure, who had persistent fever of undetected origin postoperatively and an increased (1-3)-beta-d glucan level. Gallium-67 citrate scanning showed abnormal uptake in the thyroid bilaterally. Fine needle biopsy of the thyroid revealed thyroidal invasion of Aspergillosis. Total thyroidectomy was performed and the C reactive protein level decreased to 1.01 mg/dl. The patient died of liver sepsis due to Pseudomonas aeruginosa. (1-3)-beta-d Glucan monitoring and systematic radionuclide images are useful modalities for early diagnosis of Aspergillosis.
Department of Surgery, Artificial Organ and Transplantation Division, Graduate School of Medicine, University of Tokyo, Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Yuichi
Y
Matsui
Yasuhiko
Y
Sugawara
Kunihisa
K
Tsukada
Yoji
Y
Kishi
Junji
J
Shibahara
Masatoshi
M
Makuuchi
D001228:Aspergillosis / Q000188:drug therapy; D017809:Fatal Outcome; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013966:Thyroiditis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology