AI Article Synopsis
- - A 63-year-old man with adult T-cell leukemia-lymphoma received a bone marrow transplant from an unrelated donor and was later diagnosed with invasive pulmonary aspergillosis (IPA) 17 days post-transplant.
- - He initially improved with treatment using liposomal amphotericin B, but was switched to voriconazole due to worsening kidney function, and later experienced neurological issues.
- - The patient passed away on day 62, with an autopsy revealing fungal infection in the lungs and a ruptured cerebral aneurysm, emphasizing the need for careful monitoring of transplant patients for fungal-related complications.
Article Abstract
A 63-year-old man with adult T-cell leukemia-lymphoma underwent allogeneic bone marrow transplantation from an HLA-matched unrelated donor. On day 17 after transplantation, chest computed tomography (CT) showed nodules in the lower lobes of both lungs, and invasive pulmonary aspergillosis (IPA) was suspected. Treatment with liposomal amphotericin B was started, and improvement of infectious lesions was confirmed with CT on day 28. The antifungal agent was changed to voriconazole on day 52 because of progressive renal dysfunction. Disorders of consciousness and paralysis of the left upper and lower extremities developed on day 61. Brain CT showed subcortical hemorrhage in the right parietal and occipital lobes, and the patient died on day 62. An autopsy revealed filamentous fungi, suspected to be Aspergillus, in the pulmonary nodules and a ruptured cerebral aneurysm. Although IPA occurs in 10% of transplant recipients, vigilant monitoring for mycotic cerebral aneurysms is required to prevent hematogenous dissemination of Aspergillus, which is associated with a high mortality rate.
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| http://dx.doi.org/10.11406/rinketsu.65.84 | DOI Listing |
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