Cerebral aspergillosis in a liver transplant recipient: a case report of long-term survival after combined treatment with liposomal amphotericin B and surgery

Cerebral aspergillosis is a life-threatening complication in liver transplant recipients, with mortality rates approaching 100%; treatment with amphotericin B is of limited efficacy because of its poor distribution in the cerebrospinal fluid and its systemic side effects. We report the case of a liv...

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Bibliographic Details
Published in:Journal of hepatology 1998-03, Vol.28 (3), p.518-522
Main Authors: Iemmolo, Rosa Maria, Rossanese, Andrea, Rotilio, Andrea, Mattisi, Gioacchino, Gerunda, Giorgio Enrico, Merenda, Roberto, Neri, Daniele, Crepaldi, Gaetano, Strazzabosco, Mario
Format: Article
Language:English
Subjects:
Amphotericin B - administration & dosage
Amphotericin B - therapeutic use
Antifungal Agents - administration & dosage
Antifungal Agents - therapeutic use
Aspergillosis - drug therapy
Aspergillosis - etiology
Aspergillosis - surgery
Biological and medical sciences
Brain - diagnostic imaging
Brain - pathology
Brain Diseases - drug therapy
Brain Diseases - etiology
Brain Diseases - surgery
Cerebral aspergillosis
Drug Carriers
Human mycoses
Humans
Infectious diseases
Liposomal amphotericin B
Liposomes
Liver Transplantation
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Mycoses
Mycoses of the nervous system
Postoperative Complications
Time Factors
Tomography, X-Ray Computed
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Summary:Cerebral aspergillosis is a life-threatening complication in liver transplant recipients, with mortality rates approaching 100%; treatment with amphotericin B is of limited efficacy because of its poor distribution in the cerebrospinal fluid and its systemic side effects. We report the case of a liver transplant recipient who developed recurrent cerebral Aspergillus fumigatus infection, and was successfully treated by combined surgical excision of the lesion and administration of liposomal amphotericin B. This first report of long-term complication-free survival in a liver transplant recipient suggests that therapy with liposomal amphotericin B may reduce the risk of recurrence of cerebral aspergillosis in these immunocompromised patients.
ISSN:0168-8278
1600-0641
DOI:10.1016/S0168-8278(98)80329-2