Invasive Aspergillosis Associated with a Foreign Body

Area of Science:

• Medical Mycology
• Infectious Diseases
• Surgical Pathology

Background:

• Invasive aspergillosis is a life-threatening opportunistic infection primarily affecting immunocompromised individuals.
• High mortality rates necessitate aggressive treatment strategies combining surgical intervention and antifungal medications.
• Nasal and sinus involvement can lead to significant morbidity, including oral cavity complications.

Purpose of the Study:

• To report a rare case of invasive aspergillosis with oral perforation.
• To highlight the potential role of foreign bodies as a nidus for infection.
• To emphasize the importance of prompt surgical debridement and antifungal therapy in managing such cases.

Main Methods:

• Clinical case presentation of a patient with refractory fever and invasive aspergillosis.
• Diagnostic workup including imaging and tissue examination revealing fungal infection and a foreign body.
• Treatment involved radical surgical debridement followed by high-dose liposomal amphotericin B therapy.

Main Results:

• The patient presented with nonspecific fever unresponsive to antibiotics.
• Infection spread from the nasal cavity and sinuses to the oral cavity, causing palatal destruction.
• A foreign body was identified within the infected tissue, likely serving as the source of infection.
• Successful treatment with surgical debridement and liposomal amphotericin B led to patient survival.

Conclusions:

• Invasive aspergillosis requires a multimodal treatment approach, including surgery and potent antifungals.
• Foreign bodies can act as a focus for invasive fungal infections, complicating diagnosis and treatment.
• Aggressive management, including debridement and liposomal amphotericin B, can improve outcomes in severe cases.