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Aspergillus osteomyelitis after liver transplantation

Junichi Kaneko1, Yasuhiko Sugawara, Masatoshi Makuuchi

  • 1Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|November 9, 2002
PubMed

Insights

A liver transplant patient successfully recovered from Aspergillus fumigatus osteomyelitis. Early diagnosis using (1->3)-beta-D-glucan tests and prolonged itraconazole treatment improved outcomes for invasive fungal infections.

Area of Science:

  • Medical Mycology
  • Transplantation Immunology
  • Infectious Diseases

Background:

  • Liver transplantation recipients are susceptible to opportunistic infections.
  • Invasive fungal infections, such as Aspergillus fumigatus osteomyelitis, pose a significant risk post-transplant.

Observation:

  • A 57-year-old liver transplant recipient developed femur osteomyelitis caused by Aspergillus fumigatus.
  • The patient presented with symptoms indicative of invasive fungal infection.

Findings:

  • Successful treatment involved initial amphotericin B and 5-fluorocytosine, followed by 12 months of itraconazole.
  • Plasma (1->3)-beta-D-glucan levels significantly decreased post-treatment, indicating therapeutic response.
  • The diagnostic utility of (1->3)-beta-D-glucan measurement in early detection was highlighted.

Implications:

  • Early diagnosis of invasive Aspergillus infection via (1->3)-beta-D-glucan assays is crucial.
  • Extended treatment regimens, including itraconazole, can lead to improved prognoses in transplant-associated fungal osteomyelitis.
  • This case underscores the importance of vigilant monitoring and tailored antifungal strategies in immunocompromised patients.

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