title: Invasive Primary Colonic Aspergillosis in the Immunocompetent Host without Classical Risk Factors.
abstract: Invasive aspergillosis (IA), generally considered an opportunistic infection in immunocompromised hosts, is associated with high morbidity and mortality. IA commonly occurs in the respiratory tract with isolated reports of aspergillosis infection in the nasal sinuses, central nervous system, skin, liver, and urinary tract. Extra-pulmonary aspergillosis is usually observed in disseminated disease. To date, there are a few studies regarding primary and disseminated gastrointestinal (GI) aspergillosis in immunocompromised hosts. Only a few cases of primary GI aspergillosis in non-immunocompromised hosts have been reported; of these, almost all of them involved the upper GI tract. We describe a very rare case of IA involving the lower GI tract in the patient without classical risk factors that presented as multiple colon perforations and was successfully treated by surgery and antifungal treatment. We also review related literature and discuss the characteristics and risk factors of IA in the immunocompetent hosts without classical risk factors. This case that shows IA should be considered in critically ill patients, and that primary lower GI aspergillosis may also occur in the immunocompetent hosts without classical risk factors.
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Seon Ah
authors.initials: SA
authors.lastname: Cha
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Mi Hee
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Tae Seok
authors.initials: TS
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Hyun Ho
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Kyung Yoon
authors.initials: KY
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea. cttailor@catholic.ac.kr.
authors.forename: Hoon Suk
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Seong Heon
authors.initials: SH
authors.lastname: Wie
authors.affiliation: Department of Internal Medicine, School of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Dong Chan
authors.initials: DC
authors.lastname: Jin
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D001230:Aspergillus / Q000302:isolation & purification*; D003106:Colon / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D003108:Colonic Diseases / Q000175:diagnosis / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D007121:Immunocompetence; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome; D065819:Voriconazole / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D065819:Voriconazole
keywords: Invasive aspergillosis; colon perforation; immunocompetent host