Intra-abdominal Hemorrhage Due to Splenic Vein Aneurysm Rupture Caused by Invasive Aspergillosis during Treatment for Advanced Non-small-cell Lung Cancer.

Abstract

A 71-year-old man was admitted for left-sided chest pain. He had a history of diabetes, treatment with epidermal growth factor receptor-tyrosine kinase inhibitor for advanced non-small-cell lung cancer, and corticosteroid treatment for underlying lung diseases. Chest computed tomography showed consolidations in the bilateral lower lobes, and Aspergillus fumigatus was detected by bronchoscopy. Invasive pulmonary aspergillosis was suspected, and antifungal therapy with voriconazole was initiated; however, the patient passed away suddenly. Autopsy revealed disseminated Aspergillus infection and intra-abdominal hemorrhage due to the rupture of a splenic vein aneurysm caused by Aspergillus necrotizing vasculitis, which was considered the cause of death.

• Authors: Ryutaro Hirama, Masato Kono, Takeshi Kobayashi, Yuiko Oshima, Kenichiro Takeda, Koichi Miyashita, Hideki Miwa, Akari Tsutsumi, Yoshihiro Miki, Dai Hashimoto, Yoshiro Otsuki, Hidenori Nakamura
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 62 Issue 3 Pg. 423-429 (Feb 01 2023) ISSN: 1349-7235 [Electronic] Japan
• PMID: 35732455 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antifungal Agents

Topics

• Male
• Humans
• Aged
• Carcinoma, Non-Small-Cell Lung (complications, drug therapy)
• Splenic Vein
• Antifungal Agents (therapeutic use)
• Lung Neoplasms (complications, drug therapy)
• Aspergillosis (complications, drug therapy)
• Aspergillus fumigatus
• Lung Diseases (drug therapy)
• Aneurysm, Ruptured (complications, diagnostic imaging)
• Hemorrhage (etiology, drug therapy)