[Invasive aspergillosis in an immunocompromised patient: clinical and therapeutic considerations].
The paper describes a case report of a young female with invasive aspergillosis diagnosed after brief treatment with high-dose steroids for autoimmune thrombocytopenia. Early diagnosis of invasive aspergillosis was made with cultures of tracheoaspirates and bronchoalveolar lavage and was confirmed with a transbronchial biopsy. After initial ineffective treatment with liposomal amphotericin B and dissemination from pulmonary to central nervous system involvement, treatment was switched to a combination of voriconazole and caspofungin. After marked clinical and radiological improvement, treatment was switched to the orally administered formulation of voriconazole until the complete disappearance of central nervous system lesion was observed. In the discussion section we underscore the most significant data of the host susceptibility, diagnosis of invasive aspergillosis, complications and treatment. This case ably demonstrates the efficacy of new antifungal agents, even when administered orally, and underscores the variability of host susceptibility to atypical and often unexpected invasive fungal infections.
De Rosa
Francesco Giuseppe
FG
Clinica di Malattie Infettive, Università degli studi di Torino, Italy.
Garazzino
Silvia
S
Audagnotto
Sabrina
S
Michelazzo
Marianna
M
Gobbi
Federico
F
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000209:etiology*; D001983:Bronchial Fistula / Q000150:complications; D004660:Encephalitis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D005260:Female; D016469:Fungemia / Q000188:drug therapy / Q000209:etiology*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000209:etiology; D020953:Neuroaspergillosis / Q000188:drug therapy / Q000209:etiology; D010995:Pleural Diseases / Q000150:complications; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy; D016156:Respiratory Tract Fistula / Q000150:complications; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D007166:Immunosuppressive Agents