Abstract | BACKGROUND: CASE PRESENTATION: We report a case of a 53 year old patient with T-LGL, Immune-Thrombocytopenia ( ITP) and combined antibody deficiency, who presented with fever and reduced general condition. The patient revealed a complicated infection involving the lungs and later the brain, with the presentation of vomiting and seizures. Broad microbiological testing of blood-, lung- and cerebrospinal fluid samples was inconclusive. In the absence of mycological proof, Aspergillus infection was confirmed by pathological examination of a brain specimen and finally successfully treated with liposomal amphotericin B and voriconazole, adopting a long-term treatment scheme. CONCLUSIONS: Beyond typical problems in the clinical practice involving fungal infections and hematologic malignancies, this case of invasive aspergillosis in a patient with T-LGL illustrates caveats in diagnosis, therapy and follow-up. Our data support careful ambulatory monitoring for patients with T-LGL, even in the absence of neutropenia. Especially those patients with combined hematologic malignancies and immune defects are at risk. Long-term treatment adhesion for 12 months with sufficient drug levels was necessary for sustained clearance from infection.
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Authors | Amin T Turki, Jassin Rashidi-Alavijeh, Jan Dürig, Guido Gerken, Peter-Michael Rath, Oliver Witzke |
Journal | BMC infectious diseases
(BMC Infect Dis)
Vol. 17
Issue 1
Pg. 797
(12 28 2017)
ISSN: 1471-2334 [Electronic] England |
PMID | 29281994
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antifungal Agents
- Amphotericin B
- Voriconazole
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Topics |
- Amphotericin B
(therapeutic use)
- Antifungal Agents
(therapeutic use)
- Aspergillosis
(complications, diagnosis, drug therapy)
- Aspergillus
(isolation & purification)
- Brain
(diagnostic imaging, microbiology, pathology)
- Humans
- Leukemia, Large Granular Lymphocytic
(complications, diagnosis)
- Lung
(microbiology, pathology)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Tomography, X-Ray Computed
- Voriconazole
(therapeutic use)
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