All that glitters is not gold: a case report of a diffuse peritoneal aspergillosis

Invasive aspergillosis is a rare disease, more frequently encountered in immunocompromised patients. We report a case of diffuse peritoneal aspergillosis. A 56-year old female with a history of recent renal transplantation was admitted with a suspicion of peritoneal carcinomatosis following a native computed tomography scan. Gray scale abdominal ultrasound showed multiple peritoneal masses. Upon performing contrast-enhanced ultrasound these masses demonstrated peripheral arterial enhancement and slow wash-out during the venous phase. The final histopathological examination confirmed a diagnosis of peritoneal aspergillosis. Gray scale ultrasonography in combination with contrast-enhanced ultrasonography is useful in the evaluation of intraabdominal masses. The procedures are of great value especially in patients with a high risk of contrastinduced nephropathy where contrast-enhanced CT or MRI are contraindicated.