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Successful treatment of liver aspergilloma by caspofungin acetate first-line therapy in a non-immunocompromised patient.

Bai QX, Huan Y, Wang JH, Yang LJ, Dong HJ - Int J Mol Sci (2012)

Bottom Line: However, Aspergillus infection can be observed in non-immunocompromised individuals in rare cases.Encouraging clinical and radiologic improvements were achieved in response to the antifungal salvage.Our long-term follow-up study also revealed a favorable prognosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, State Allogeneic Hematopoietic Stem Cell Transplantation Center, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China; E-Mails: wangjh_2@163.com (J.-H.W.); yanglj_xj@126.com (L.-J.Y.); dhongjuanyahoo@163.com (H.-J.D.).

ABSTRACT
Aspergillosis remains to be a life-threatening complication in immunocompromised patients. However, Aspergillus infection can be observed in non-immunocompromised individuals in rare cases. We report a case of liver aspergilloma in a chronic aplastic anemia patient under relatively intact immune status. Therapeutic strategy for this rare condition was extensively discussed and caspofungin acetate single agent first-line therapy was applied after careful consideration. Encouraging clinical and radiologic improvements were achieved in response to the antifungal salvage. Our long-term follow-up study also revealed a favorable prognosis. Based on this experience, we suggest caspofungin acetate as first-line therapy for treatment plans of liver aspergilloma.

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Related in: MedlinePlus

Horizontal abdominal MRI image in May 2006 shows multiple solid nodules in the right lobe of the liver (arrows indicated).
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f1-ijms-13-11063: Horizontal abdominal MRI image in May 2006 shows multiple solid nodules in the right lobe of the liver (arrows indicated).

Mentions: On admission, the patient had a body temperature of 36.5 °C, pulse of 75 beats per minute, blood pressure of 120/80 mmHg, respiratory rate of 16 per minute, and oxygen saturation of 98% on room air. Her abdomen was soft to palpation. Full blood test showed leukocyte count of 3.0 × 109/L, hemoglobin 110 g/L and platelet 23 × 109/L. Immunological studies, including quantitative immunoglobulins analysis, CD4/CD8 T lymphocyte ratio, and delayed hypersensitivity skin tests, were all normal. No predisposing disease associated with immunosuppression, such as diabetes mellitus, was found. Her human immunodeficiency virus status was negative, indicating the patient was in a non-immunocompromised condition. Abdominal ultrasonography and magnetic resonance imaging (MRI) showed multiple heterogeneous solid nodules in the right lobe of the liver (Figure 1). No abdominal lymphadenopathy or effusions were visible.


Successful treatment of liver aspergilloma by caspofungin acetate first-line therapy in a non-immunocompromised patient.

Bai QX, Huan Y, Wang JH, Yang LJ, Dong HJ - Int J Mol Sci (2012)

Horizontal abdominal MRI image in May 2006 shows multiple solid nodules in the right lobe of the liver (arrows indicated).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3472730&req=5

f1-ijms-13-11063: Horizontal abdominal MRI image in May 2006 shows multiple solid nodules in the right lobe of the liver (arrows indicated).
Mentions: On admission, the patient had a body temperature of 36.5 °C, pulse of 75 beats per minute, blood pressure of 120/80 mmHg, respiratory rate of 16 per minute, and oxygen saturation of 98% on room air. Her abdomen was soft to palpation. Full blood test showed leukocyte count of 3.0 × 109/L, hemoglobin 110 g/L and platelet 23 × 109/L. Immunological studies, including quantitative immunoglobulins analysis, CD4/CD8 T lymphocyte ratio, and delayed hypersensitivity skin tests, were all normal. No predisposing disease associated with immunosuppression, such as diabetes mellitus, was found. Her human immunodeficiency virus status was negative, indicating the patient was in a non-immunocompromised condition. Abdominal ultrasonography and magnetic resonance imaging (MRI) showed multiple heterogeneous solid nodules in the right lobe of the liver (Figure 1). No abdominal lymphadenopathy or effusions were visible.

Bottom Line: However, Aspergillus infection can be observed in non-immunocompromised individuals in rare cases.Encouraging clinical and radiologic improvements were achieved in response to the antifungal salvage.Our long-term follow-up study also revealed a favorable prognosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, State Allogeneic Hematopoietic Stem Cell Transplantation Center, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China; E-Mails: wangjh_2@163.com (J.-H.W.); yanglj_xj@126.com (L.-J.Y.); dhongjuanyahoo@163.com (H.-J.D.).

ABSTRACT
Aspergillosis remains to be a life-threatening complication in immunocompromised patients. However, Aspergillus infection can be observed in non-immunocompromised individuals in rare cases. We report a case of liver aspergilloma in a chronic aplastic anemia patient under relatively intact immune status. Therapeutic strategy for this rare condition was extensively discussed and caspofungin acetate single agent first-line therapy was applied after careful consideration. Encouraging clinical and radiologic improvements were achieved in response to the antifungal salvage. Our long-term follow-up study also revealed a favorable prognosis. Based on this experience, we suggest caspofungin acetate as first-line therapy for treatment plans of liver aspergilloma.

Show MeSH
Related in: MedlinePlus