title: Combination antifungal therapy and surgery for the treatment of invasive pulmonary aspergillosis after hematopoietic stem cell transplantation.
abstract: An 8-year old boy, affected by severe aplastic anemia, developed a probable pulmonary invasive aspergillosis (IA) early after a second unrelated allogeneic hematopoietic stem cell transplant (HSCT). He was treated promptly with the combination of liposomal amphotericin B and caspofungin. Despite the initial stabilization, the patient deteriorated and the antifungal therapy was switched to voriconazole and caspofungin. The patient gradually improved and was discharged home on day +29 post-HSCT on oral voriconazole. On day +119, a sudden episode of hemoptysis occurred and a right superior lobectomy was decided to remove the residual aspergilloma. The patient is now alive and well more than 24 months from HSCT. This case demonstrated that antifungal combination therapy and surgery are valid options to cure pulmonary IA even in patients at high-risk and severely immunosuppressed.
authors.affiliation: Pediatric Hematology Oncology, Department of Pediatrics, Padova;
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.forename: Marta
authors.initials: M
authors.lastname: Pillon
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Calore
authors.forename: Rita
authors.initials: R
authors.lastname: Alaggio
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Gamba
authors.forename: Silvia
authors.initials: S
authors.lastname: Bergamo
authors.forename: Chiara
authors.initials: C
authors.lastname: Mainardi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Toffolutti
authors.forename: Anna
authors.initials: A
authors.lastname: Pegoraro
authors.forename: Chiara
authors.initials: C
authors.lastname: Messina