Aspergillus vertebral osteomyelitis and ureteral obstruction after liver transplantation

Area of Science:

• Medical Mycology
• Transplant Infectious Diseases
• Urology

Background:

• Aspergillus osteomyelitis is a known complication in solid organ transplant recipients, often presenting as vertebral osteomyelitis.
• Ureteral obstruction by Aspergillus fungal balls is uncommon.

Observation:

• A hepatic transplant recipient presented with simultaneous vertebral osteomyelitis and ureteral obstruction.
• The causative agent was identified as Aspergillus flavus.

Findings:

• This case represents a rare co-occurrence of invasive aspergillosis affecting both the spine and the urinary tract.
• Successful treatment was achieved using a sequential regimen of intravenous and oral itraconazole.

Implications:

• This case underscores the importance of considering invasive aspergillosis in transplant recipients with unusual presentations.
• It highlights the efficacy of itraconazole in treating complex Aspergillus infections in this immunocompromised population.
• Early diagnosis and appropriate antifungal therapy are crucial for favorable outcomes in transplant-associated invasive fungal infections.