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Pulmonary aspergillosis complicated by osteomyelitis
R De Bock1, D Schrijvers, M Peetermans
1Department of Haematology, Universitair Ziekenhuis Antwerpen, Edegem.
Acta Clinica Belgica
|January 1, 1991
Summary
Aplastic anemia complicated by invasive pulmonary aspergillosis and rib osteomyelitis was treated with AmBisome after amphotericin B caused kidney issues. Successful treatment led to patient recovery and immunity restoration.
Area of Science:
- Infectious Diseases
- Hematology
- Mycology
Background:
- Aplastic anemia patients have compromised immunity, increasing susceptibility to opportunistic infections.
- Invasive aspergillosis is a severe fungal infection, particularly in immunocompromised individuals.
- Osteomyelitis, a bone infection, can arise from contiguous spread of infection.
Observation:
- A patient with aplastic anemia developed invasive pulmonary aspergillosis.
- The aspergillosis progressed to osteomyelitis of the ribs.
- Diagnosis was confirmed by soft tissue biopsy and isolation of Aspergillus fumigatus.
Findings:
- Initial treatment with amphotericin B resulted in nephrotoxicity (kidney function disturbances).
- Liposomal amphotericin B (AmBisome) was substituted and well-tolerated.
- The patient achieved clinical cure and recovered immune function.
Implications:
- This case highlights the challenges in treating invasive fungal infections in aplastic anemia.
- Liposomal amphotericin B offers a safer alternative in patients with renal intolerance.
- Successful management can lead to recovery of immunity and favorable patient outcomes.