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Invasive Aspergillus sinusitis during bone marrow transplantation

C F Verschraegen1, K W van Besien, C Dignani

  • 1Section of Gynecology Medical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, USA.

Scandinavian Journal of Infectious Diseases
|January 1, 1997
PubMed

Insights

Aspergillus sinusitis in bone marrow transplant patients can be fatal. This case study shows a multidisciplinary approach including surgery, amphotericin B, and granulocyte transfusions can cure invasive Aspergillus flavus sinusitis.

Area of Science:

  • Medical Mycology
  • Hematology
  • Transplantation Immunology

Background:

  • Aspergillus sinusitis poses a significant lethal threat to immunocompromised patients, particularly those undergoing bone marrow transplantation.
  • Early diagnosis and intervention are critical for managing invasive fungal infections in this vulnerable population.

Observation:

  • A patient with refractory acute myelogenous leukemia developed Aspergillus flavus sinusitis prior to allogeneic bone marrow transplantation.
  • The sinusitis exacerbated during the neutropenic phase, necessitating aggressive management.

Findings:

  • A multidisciplinary approach combining Caldwell-Luc surgery, prolonged amphotericin B colloidal dispersion (ABCD) therapy (7 months), and granulocyte transfusions achieved a cure.
  • Granulocyte transfusions were crucial in the salvage setting, supporting the patient through the pre-engraftment period.

Implications:

  • Aggressive, multimodality treatment strategies can lead to successful outcomes for invasive aspergillus sinusitis in immunosuppressed patients.
  • Successful management of invasive fungal infections may not necessarily preclude allogeneic stem cell transplantation.

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