title: Invasive Aspergillosis of the Stomach and Co-infection With Candida krusei in a Patient With Terminal Liver Failure: A Case Report.
abstract: Invasive aspergillosis (IA) is diagnosed almost exclusively in immunocompromised patients. It is located mainly in the lungs or paranasal sinuses, but occasionally other organs and the gastrointestinal tract may also be affected either alone or as a part of a disseminated disease. The main risk factors predisposing to IA are neutropenia, immunosuppressive and steroid therapy, as well as severe underlying disease. Despite progress in diagnostics and therapy of IA, it is still characterized by a high mortality rate. In the disseminated aspergillosis of the gastrointestinal tract, mainly the small or large intestine are affected, rarely the upper gastrointestinal tract. To our best knowledge only a very few cases of IA of the gastric wall have been reported so far in the literature. We describe a unique case of this very rare location of IA in the stomach in a patient who underwent orthotopic liver transplantation in the course of active IA and Candida krusei infection of the stomach wall. The patient's condition improved on combination therapy of voriconazole and caspofungin.
authors.affiliation: Department of Microbiology, Central Clinical Hospital in Warsaw, Warsaw, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Sulik-Tyszka
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: W
authors.initials: W
authors.lastname: Figiel
authors.affiliation: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Krawczyk
authors.affiliation: Department of Microbiology, Central Clinical Hospital in Warsaw, Warsaw, Poland; Department of Dental Microbiology, Medical University of Warsaw, Warsaw, Poland. Electronic address: marta.wroblewska@wum.edu.pl.
authors.forename: M
authors.initials: M
authors.lastname: Wróblewska
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D002177:Candidiasis / Q000150:complications*; D000077336:Caspofungin; D060085:Coinfection / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D054714:Echinocandins / Q000627:therapeutic use; D058625:End Stage Liver Disease / Q000188:drug therapy / Q000601:surgery; D005753:Gastric Mucosa / Q000382:microbiology; D006801:Humans; D055666:Lipopeptides / Q000627:therapeutic use; D016031:Liver Transplantation; D013272:Stomach Diseases / Q000150:complications* / Q000382:microbiology*; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077336:Caspofungin; D065819:Voriconazole