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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

Profound Aspergillus hyphae were observed in the necrotic liver specimen. Magnification at 400×, bar = 200 μm.
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f2-ijms-13-11063: Profound Aspergillus hyphae were observed in the necrotic liver specimen. Magnification at 400×, bar = 200 μm.

Mentions: Two weeks after admission, ultrasound-guided fine needle aspiration was performed. On histopathological examination, abundant fungal hyphae were observed in the background of necrosis and chronic inflammation (Figure 2). A. fumigatus was subsequently isolated and cultured from the biopsy aspirate. Bacterial and acid-fast smears and cultures were negative. Pulmonary aspergillosis with liver dissemination was suspected, but the patient denied relevant infectious and occupational exposure history. A comprehensive whole body evaluation, including chest and paranasal sinus computed tomography (CT), did not indicated aspergillosis lesions. Regular GM tests continued to be negative. On the basis of these findings, we concluded the diagnosis of liver aspergilloma.


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)

Profound Aspergillus hyphae were observed in the necrotic liver specimen. Magnification at 400×, bar = 200 μm.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f2-ijms-13-11063: Profound Aspergillus hyphae were observed in the necrotic liver specimen. Magnification at 400×, bar = 200 μm.
Mentions: Two weeks after admission, ultrasound-guided fine needle aspiration was performed. On histopathological examination, abundant fungal hyphae were observed in the background of necrosis and chronic inflammation (Figure 2). A. fumigatus was subsequently isolated and cultured from the biopsy aspirate. Bacterial and acid-fast smears and cultures were negative. Pulmonary aspergillosis with liver dissemination was suspected, but the patient denied relevant infectious and occupational exposure history. A comprehensive whole body evaluation, including chest and paranasal sinus computed tomography (CT), did not indicated aspergillosis lesions. Regular GM tests continued to be negative. On the basis of these findings, we concluded the diagnosis of liver aspergilloma.

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