Ante-mortem diagnosis of localized invasive esophageal aspergillosis in a patient with acute myeloid leukemia

Opportunistic infection with invasive aspergillosis (IA) is increasingly frequent in immunocompromised patients, particularly in those with hematological malignancies. In this setting, IA typically involves the lung, with extra-pulmonary involvement usually occurring in the setting of disseminated i...

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Bibliographic Details
Published in:Leukemia & lymphoma 2005-04, Vol.46 (4), p.603-605
Main Authors: Chionh, Fiona, Herbert, Kirsten E, Seymour, John F, Prince, H Miles, Wolf, Max, Zimet, Alan, Tam, Constantine, Kennedy, Glen A
Format: Article
Language:English
Subjects:
Acute Disease
acute myeloid leukemia
Aged
Aspergillosis
Aspergillosis - complications
Aspergillosis - diagnosis
Aspergillosis - drug therapy
Aspergillus
Esophageal Diseases - complications
Esophageal Diseases - diagnosis
gastrointestinal infection
Gastroscopy
Humans
Leukemia, Myeloid - complications
Leukemia, Myeloid - therapy
Male
Neoplasm Invasiveness
opportunistic
Opportunistic Infections - complications
Remission Induction
voriconazole
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Summary:Opportunistic infection with invasive aspergillosis (IA) is increasingly frequent in immunocompromised patients, particularly in those with hematological malignancies. In this setting, IA typically involves the lung, with extra-pulmonary involvement usually occurring in the setting of disseminated infection. We report a case of localized gastrointestinal IA complicating induction chemotherapy for acute myeloid leukemia (AML). Oral voriconazole was successful as primary treatment, with no evidence of progressive infection despite further myelosuppressive chemotherapy. A review of the literature suggests that although localized gastrointestinal IA is rare, involvement of the gastrointestinal tract is not uncommon in disseminated infection. Thus, in patients with hematological malignancies who develop significant gastrointestinal symptoms, we recommend that endoscopic investigations and biopsies are performed to exclude IA as a potential cause.
ISSN:1042-8194
1029-2403
DOI:10.1080/10428190400025138