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Invasive aspergillosis in a patient with end stage renal disease

Neslihan Cicek1, Nurdan Yildiz1,2, Eda Kepenekli Kadayifci2

  • 1Marmara University School of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey.

Medical Mycology Case Reports
|August 2, 2017
PubMed

Insights

Invasive aspergillosis, a serious fungal infection, rarely affects those with end-stage renal disease (ESRD). This case highlights a fatal outcome in a young ESRD patient due to delayed diagnosis and treatment.

Area of Science:

  • Medical Mycology
  • Nephrology
  • Infectious Diseases

Background:

  • Invasive aspergillosis is a severe opportunistic infection, primarily affecting immunocompromised individuals.
  • End-stage renal disease (ESRD) represents a significant risk factor for invasive fungal infections.
  • Prompt diagnosis and management are crucial for improving outcomes in invasive aspergillosis.

Purpose of the Study:

  • To report a rare case of invasive aspergillosis in a pediatric patient with ESRD.
  • To illustrate the diagnostic challenges and rapid progression of the disease in this population.
  • To emphasize the importance of considering invasive fungal infections in immunocompromised patients presenting with atypical symptoms.

Main Methods:

  • Case report of a 15-year-old boy with ESRD.
  • Initial diagnosis of lobar pneumonia and peritonitis.
  • Advanced imaging (MRI) revealing spinal cord compression and intracranial abscesses.
  • Fungal hyphae identified on biopsy confirming Aspergillus species infection.

Main Results:

  • The patient presented with neurological symptoms including lower extremity weakness and convulsions.
  • Imaging demonstrated a lung mass compressing the spinal cord and intracranial hemorrhagic abscesses.
  • Histopathological examination confirmed invasive aspergillosis.
  • Despite medical intervention, the patient succumbed to the infection on the 12th day.

Conclusions:

  • Invasive aspergillosis can present insidiously and progress rapidly in ESRD patients.
  • Neurological complications can be a presenting feature of disseminated aspergillosis.
  • Early recognition and aggressive antifungal therapy are essential, though prognosis remains poor in advanced cases.
Keywords:
AspergillosisCAPD, continuous ambulatory peritoneal dialysisCNS, central nervous systemESRD, end stage renal diseaseEnd stage renal diseaseIA, invasive aspergillosisMRI, magnetic resonance imagingPeritoneal dialysis

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