title: Prostatic and renal aspergillosis due to Aspergillus fumigatus in a patient receiving alemtuzumab for chronic lymphocytic leukaemia.
abstract: OBJECTIVE
  Treatment of chronic lymphocytic leukaemia (CLL) is rapidly evolving, with emerging new drugs. Alemtuzumab is a monoclonal antibody recognizing CD52 antigen approved in the treatment of relapsing-refractory CLL. A frequent side effect is the immunosuppression and patients treated with alemtuzumab risk to develop fungal infections such as aspergillosis.
  
  
  METHODS
  This case report is about a patient who developed an uncommon localization of aspergillosis: prostatic and renal, after a treatment by alemtuzumab monotherapy. During the week 8 of alemtuzumab, the patient presented fever, urinary frequency and urologic symptoms. Persistance of fever with common antibiotherapy led to realize a tomography that showed prostatic and renal abscess (70mm and 29mm). It was decided to realize a prostatic biopsy.
  
  
  RESULTS
  Histological findings showed suppurative abscess with ischemic necrosis and fungal proliferation, with branched fungal hyphae. Direct examination was negative. Culture on Sabouraud's agar revealed a mould identified as Aspergillus fumigatus. The organism was susceptible to voriconazole (MIC: voriconazole 0,25ug/mL).
  
  
  CONCLUSIONS
  Because of the main side effect of alemtuzumab is immunosuppression, we have to research fungal infections such as Aspergillosis, particularly in patients with fever resistant to common antibiotherapy.
authors.affiliation: Service d'hématologie clinique, hôpital Archet 1, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 2, France. Electronic address: clemence413@hotmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Roux
authors.forename: A
authors.initials: A
authors.lastname: Thyss
authors.forename: M
authors.initials: M
authors.lastname: Gari-Toussaint
mesh_terms: D000038:Abscess / Q000209:etiology / Q000382:microbiology*; D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000074323:Alemtuzumab; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001228:Aspergillosis / Q000209:etiology / Q000382:microbiology*; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D025141:Drug Resistance, Fungal; D006801:Humans; D016867:Immunocompromised Host; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000209:etiology / Q000382:microbiology*; D011472:Prostatitis / Q000209:etiology / Q000382:microbiology*; D016879:Salvage Therapy; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D061067:Antibodies, Monoclonal, Humanized; D000935:Antifungal Agents; D000970:Antineoplastic Agents; D000074323:Alemtuzumab; D014633:Valine; D065819:Voriconazole; D000077483:Valacyclovir; D000212:Acyclovir
keywords: Alemtezumab; Alemtuzumab; Aspergillus fumigatus; Kidney; Leucémie; Leukemia; Prostate; Rein