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Development of Aspergillus sinusitis in a patient receiving amphotericin B. Treatment with granulocyte transfusions
Abstract:
Fulminant Aspergillus sinusitis is a disease of immunocompromised hosts strongly associated with neutropenia. A case of sinusitis due to Aspergillus flavus that developed in a patient with acute leukemia during the third week of treatment with amphotericin B is described. Indium 111-labeled white blood cell scanning demonstrated uptake of granulocytes into the involved sinuses. Thereafter, use of granulocyte transfusions was associated with stabilization of the patient's clinical course.
Insights
Fulminant Aspergillus sinusitis, a severe fungal infection, can affect immunocompromised patients. This case highlights granulocyte transfusions aiding recovery in acute leukemia during antifungal treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Hematology
Background:
- Fulminant Aspergillus sinusitis is a rare but serious opportunistic infection.
- It primarily affects immunocompromised individuals, often linked to neutropenia.
- Acute leukemia patients undergoing chemotherapy are particularly vulnerable.
Observation:
- A case of invasive sinusitis caused by Aspergillus flavus is presented.
- The patient had acute leukemia and was receiving amphotericin B treatment.
- Indium 111-labeled white blood cell scanning showed granulocyte accumulation in the sinuses.
Findings:
- The patient's sinusitis progressed despite antifungal therapy.
- Granulocyte transfusions were administered to bolster the immune response.
- Following transfusions, the patient's clinical condition stabilized.
Implications:
- This case suggests granulocyte transfusions may be a valuable adjunctive therapy.
- It underscores the importance of early diagnosis and aggressive management in invasive fungal sinusitis.
- Further research into immune-modulating strategies for invasive aspergillosis in neutropenic hosts is warranted.