title: Successful Treatment of Combined Aspergillus and Cytomegalovirus Abscess in Brain and Lung After Liver Transplant for Toxic Fulminant Hepatitis.
abstract: Invasive aspergillosis is one of the most important and fatal complications after liver transplant, especially in patients with involvement of the central nervous system. We present a case of a patient who developed cerebral and pulmonary aspergillosis, coinfected with cytomegalovirus, after liver transplant for toxic fulminant hepatitis. The patient was treated successfully with neurosurgical intervention and voriconazole. Voriconazole is considered more effective in cerebral aspergillosis than other anti-fungal agents due to the greater penetration into central nervous system and higher cerebrospinal fluid and brain tissue levels.
authors.affiliation: From the Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Tae-Seok
authors.initials: TS
authors.lastname: Kim
authors.forename: Keun Soo
authors.initials: KS
authors.lastname: Ahn
authors.forename: Yong Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Hyoung Tae
authors.initials: HT
authors.lastname: Kim
authors.forename: Byoung Kuk
authors.initials: BK
authors.lastname: Jang
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Hwang
authors.forename: Il-Man
authors.initials: IM
authors.lastname: Kim
authors.forename: Yu Na
authors.initials: YN
authors.lastname: Kang
authors.forename: Koo Jeong
authors.initials: KJ
authors.lastname: Kang
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001706:Biopsy; D001922:Brain Abscess / Q000276:immunology / Q000382:microbiology / Q000628:therapy* / Q000821:virology; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003586:Cytomegalovirus Infections / Q000276:immunology / Q000628:therapy* / Q000821:virology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D055744:Invasive Pulmonary Aspergillosis / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects*; D008169:Lung Abscess / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009145:Mushroom Poisoning / Q000150:complications* / Q000175:diagnosis; D020953:Neuroaspergillosis / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D019635:Neurosurgical Procedures; D009894:Opportunistic Infections / Q000276:immunology / Q000382:microbiology / Q000628:therapy* / Q000821:virology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D065819:Voriconazole / Q000627:therapeutic use*
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D065819:Voriconazole