Chasan R, Patel G, Malone A, Finn M, Huprikar S
Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Transpl Infect Dis. 2013 Oct;15(5):E201-5. doi: 10.1111/tid.12127. Epub 2013 Aug 27.
Invasive aspergillosis (IA) contributes significantly to the burden of infectious complications in heavily immunosuppressed patients with acute leukemia. The infection is typically acquired via inhalation into the respiratory tract, and the lungs are most commonly involved. However, disseminated disease may occur and reports of isolated extrapulmonary infection suggest the gastrointestinal tract is likely an additional portal of entry for this organism. We describe a case of primary hepatic aspergillosis in a patient with acute myelogenous leukemia. The patient did not respond to medical therapy with antifungals and ultimately required surgical exploration and drainage. IA should be considered in an immunosuppressed patient with hepatic abscesses and may require a combined surgical and medical approach to therapy.
侵袭性曲霉病(IA)在急性白血病的重度免疫抑制患者的感染并发症负担中占显著比例。该感染通常通过吸入进入呼吸道而获得,肺部最常受累。然而,可能会发生播散性疾病,关于孤立性肺外感染的报道表明胃肠道可能是该病原体的另一个侵入门户。我们描述了一例急性髓性白血病患者发生原发性肝曲霉病的病例。该患者对抗真菌药物治疗无反应,最终需要手术探查和引流。对于患有肝脓肿的免疫抑制患者应考虑IA,可能需要手术和药物联合治疗。