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Primary gastrointestinal aspergillosis: a case report and literature review

Infez Med. 2019 Mar 1;27(1):85-92.

Abstract

Invasive aspergillosis is a severe infection that generally involves the lungs. Primary gastrointestinal aspergillosis is the least common form of invasive aspergillosis. A patient aged 65 years developed a febrile neutropenic episode following an autologous stem cell transplant for plasmacytoid variant diffuse large B-cell gastric non-Hodgkin's lymphoma. He had abdominal pain on the second day of the febrile neutropenic episode and ileus occurred on the sixth day. His general condition deteriorated despite broad spectrum antibiotics and caspofungin treatment, and intestinal perforation occurred on the nineteenth day of the febrile neutropenic episode. Pathological examination of the resected jejunum and ileum revealed mould hyphae compatible with aspergillus. The patient died due to massive gastrointestinal bleeding on the fifth post-operative day. Although a rare condition, primary gastrointestinal aspergillosis should be kept in mind while treating neutropenic patients with gastrointestinal symptoms.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Aspergillosis / complications*
  • Aspergillosis / diagnostic imaging
  • Fatal Outcome
  • Febrile Neutropenia / microbiology*
  • Gastrointestinal Diseases / diagnostic imaging
  • Gastrointestinal Diseases / microbiology*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Ileus / etiology
  • Immunocompromised Host
  • Invasive Fungal Infections / diagnostic imaging
  • Invasive Fungal Infections / microbiology*
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Male
  • Stomach Neoplasms / therapy