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[Multivisceral infarcts are complication of invasive aspergillosis]
E Vázquez Muñoz1, M Morado Arias, J A Sobrino Daza
1Servicios de Hematología y Cardiología, Hospital Universitario La Paz, Madrid.
Abstract:
Aspergillus fumigatus is one of the species of Aspergillus that causes aspergillosis. The clinical picture of invasive-disseminated aspergillosis is generally characterized by fever and respiratory distress that usually follows a fatal course. This form of intensive aspergillosis is suffered by severely immunossuppressed patients. There is another clinical form of severe aspergillosis, aortic aspergillosis, that appears after cardiac surgery. We present two cases of invasive aspergillosis complicated by multiple visceral infarcts involving the liver, spleen, kidneys, pancreas, thiroid and brain. Infarcts were confirmed in necropsy and appeared to be caused by an overwhelming amount of intravascular hiphae, which were observed in the infarcted areas acting forming septic embolus. We believe that multi-visceral infarcts are an underestimated complication of invasive aspergillosis. Given the progressive increase in the population of immunossuppressed patients, clinicians have to aware of all the possible presentations of invasive aspergillosis.
Insights
Invasive aspergillosis can cause fatal multi-visceral infarcts in severely immunocompromised patients. This study highlights intravascular hyphae as a cause of septic emboli, an underestimated complication.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pathology
Background:
- Aspergillosis, caused by Aspergillus fumigatus, presents clinically with fever and respiratory distress, often fatal in severely immunocompromised individuals.
- Aortic aspergillosis is a severe form occurring post-cardiac surgery.
- Invasive aspergillosis requires awareness of diverse clinical manifestations.
Observation:
- Two cases of invasive aspergillosis complicated by multiple visceral infarcts are presented.
- Infarcts involved the liver, spleen, kidneys, pancreas, thyroid, and brain.
- Necropsy confirmed intravascular hyphae within infarcted areas, forming septic emboli.
Findings:
- Intravascular hyphae of Aspergillus fumigatus can lead to septic emboli.
- Multi-visceral infarcts are a significant, potentially underestimated complication of invasive aspergillosis.
- The study emphasizes the need for vigilance regarding this fungal infection's presentations.
Implications:
- Clinicians must recognize multi-visceral infarcts as a potential consequence of invasive aspergillosis.
- Increased awareness is crucial given the rising population of immunocompromised patients.
- Early diagnosis and management are vital for improving outcomes in invasive aspergillosis.