Invasive Aspergillus sinusitis During Bone Marrow Transplantation

Aspergillus sinusitis is usually a lethal condition in bone marrow transplanted patients. We report the case of a patient known to have a sinus infection with Aspergillus flavus before treatment with allogenic bone marrow transplantation for a refractory-acute myelogenous leukemia. Exacerbation of t...

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Bibliographic Details
Published in:Scandinavian journal of infectious diseases 1997, Vol.29 (4), p.436-438
Main Authors: Verschraegen, Claire F., Van Besien, Koen W., Dignani, Cecilia, Hester, Jeane P., Andersson, Borje S., Anaissie, Elias
Format: Article
Language:English
Subjects:
Adult
Amphotericin B - administration & dosage
Amphotericin B - therapeutic use
Antifungal Agents - administration & dosage
Antifungal Agents - therapeutic use
Aspergillosis - complications
Aspergillosis - diagnosis
Aspergillosis - drug therapy
Biological and medical sciences
Bone Marrow Transplantation - adverse effects
Ent and stomatologic mycoses
Female
Granulocytes
Human mycoses
Humans
Immunocompromised Host
Infectious diseases
Leukemia, Myeloid, Acute - complications
Leukocyte Transfusion
Medical sciences
Mycoses
Neutropenia - microbiology
Sinusitis - complications
Sinusitis - microbiology
Sinusitis - surgery
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Summary:Aspergillus sinusitis is usually a lethal condition in bone marrow transplanted patients. We report the case of a patient known to have a sinus infection with Aspergillus flavus before treatment with allogenic bone marrow transplantation for a refractory-acute myelogenous leukemia. Exacerbation of the sinusitis during the neutropenic period required a multidisciplinary approach. Cure was achieved after treatment with a combination of surgery (Caldwell-Luc procedure), long term ABCD (amphotericin B colloidal dispersion) therapy (7 months) and granulocyte transfusions during the period preceding engraftment. The use of granulocyte transfusion in this salvage setting is discussed. Aggressive multimodality management of aspergillus sinusitis in immunosuppressed patients may lead to a cure and might not preclude allogenic transplantation.
ISSN:0036-5548
1651-1980
DOI:10.3109/00365549709011849