Acute isolated appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia.
New Microbiol
; 39(1): 65-9, 2016 Jan.
Article
in En
| MEDLINE
| ID: mdl-26922988
ABSTRACT
We describe a case of isolated acute appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia (AML) treated according to the AIEOP AML 2002/01 protocol. Despite prophylaxis with acyclovir, ciprofloxacin and fluconazole administered during the neutropenic phase, 16 days after the end of chemotherapy the child developed fever without identified infective foci, which prompted a therapy shift to meropenem and liposomial amphotericin B. After five days of persisting fever he developed ingravescent abdominal lower right quadrant pain. Abdominal ultrasound was consistent with acute appendicitis and he underwent appendectomy with prompt defervescence. PAS+ fungal elements were found at histopathology examination of the resected vermiform appendix, and galactomannan was low positive. A. carneus, a rare species of Aspergillus formerly placed in section Flavipedes and recently considered a member of section Terrei, was identified in the specimen. Treatment with voriconazole was promptly started with success. No other site of Aspergillus localization was detected. Appendicitis is rarely caused by fungal organisms and isolated intestinal aspergillosis without pulmonary infection is unusual. To our knowledge, this is the first report of infection due to A. carneus in a child and in a primary gastrointestinal infection.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aspergillosis
/
Aspergillus
/
Leukemia, Myeloid, Acute
/
Antifungal Agents
/
Neutropenia
Type of study:
Guideline
/
Prognostic_studies
Limits:
Child
/
Humans
/
Male
Language:
En
Journal:
New Microbiol
Journal subject:
MICROBIOLOGIA
Year:
2016
Document type:
Article
Affiliation country:
Italy