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Invasive Aspergillosis of the Stomach and Co-infection With Candida krusei in a Patient With Terminal Liver Failure:

B Sulik-Tyszka1, W Figiel2, M Krawczyk2

  • 1Department of Microbiology, Central Clinical Hospital in Warsaw, Warsaw, Poland.

Transplantation Proceedings
|December 10, 2016
PubMed

Insights

Invasive aspergillosis (IA) is a serious fungal infection in immunocompromised patients. This case highlights a rare gastric wall IA in a liver transplant recipient, successfully treated with combination antifungal therapy.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Transplantation Medicine

Background:

  • Invasive aspergillosis (IA) predominantly affects immunocompromised individuals, typically manifesting in the lungs or sinuses.
  • Risk factors include neutropenia, immunosuppressive therapy, and severe underlying conditions, contributing to high IA mortality rates.
  • Gastrointestinal tract involvement in IA is uncommon, with gastric wall IA being exceedingly rare.

Observation:

  • This report details a unique case of IA affecting the gastric wall.
  • The patient had undergone orthotopic liver transplantation and presented with concurrent Candida krusei infection of the stomach wall.
  • This represents a very rare instance of IA localized to the gastric wall.

Findings:

  • The patient's gastric wall IA and Candida krusei infection were diagnosed during the post-transplant period.
  • Successful management was achieved through a combination therapy regimen.
  • The treatment involved voriconazole and caspofungin, demonstrating efficacy in this complex scenario.

Implications:

  • This case underscores the importance of considering rare IA presentations, even in the upper gastrointestinal tract.
  • It highlights the potential for IA to occur in solid organ transplant recipients.
  • The successful outcome emphasizes the role of combination antifungal therapy in managing disseminated and rare IA infections.

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