title: Invasive aspergillosis in a user of inhaled cocaine: rhinosinusitis with bone and cartilage destruction.
abstract: Aspergillosis is an infection caused by saprophytic fungi of the genus Aspergillus, which typically occurs in immunosuppressed individuals, but has also been reported in immunocompetent patients. The main routes of entry are the respiratory tract, skin, cornea, and ear, and the infection may be localized or disseminated by contiguity or vascular invasion. We report a severe case of rhinosinusitis with cutaneous involvement, caused by invasive aspergillosis, in an immunocompetent user of inhaled cocaine. Invasive aspergillosis related to cocaine abuse has not yet been reported in the literature. After itraconazole treatment and surgical debridement, complete clinical remission was achieved. Nasal reconstruction with a skin graft over a silicone prosthesis resulted in a satisfactory esthetic outcome.
authors.affiliation: Instituto de Dermatologia Professor Rubem Davi Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Luna
authors.initials: L
authors.lastname: Azulay-Abulafia
authors.affiliation: Dermatologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Maria Auxiliadora Jeunon
authors.initials: MA
authors.lastname: Sousa
authors.affiliation: Microbiologia, Clínica Privada, Rio de Janeiro, RJ, Brasil.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pussanti
authors.affiliation: Dermatologia, Clínica Privada, Rio de Janeiro, RJ, Brasil.
authors.forename: Daniel Dal'Asta
authors.initials: DD
authors.lastname: Coimbra
authors.affiliation: Corporación Universitaria Rafael Nunez de Cartagena, Cartagena, Colombia.
authors.forename: Hernando
authors.initials: H
authors.lastname: Vega
authors.affiliation: Instituto de Dermatologia Professor Rubem Davi Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
authors.forename: Fred
authors.initials: F
authors.lastname: Bernardes Filho
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000209:etiology*; D019970:Cocaine-Related Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D009667:Nose Deformities, Acquired / Q000382:microbiology*; D012220:Rhinitis / Q000382:microbiology*; D012852:Sinusitis / Q000382:microbiology*