Document Detail


Vertebral osteomyelitis due to Aspergillus fumigatus in a patient with chronic granulomatous disease successfully treated with antifungal agents and interferon-gamma.
MedLine Citation:
PMID:  19886765     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a case of invasive aspergillosis due to Aspergillus fumigatus involving the cervical and thoracic vertebrae and upper mediastinum of a 17 year-old Saudi male with chronic granulomatous disease (CGD). The patient did not respond to a long course of liposomal amphotericin B but did to surgical drainage and a combination of caspofungin and itraconazole with subsequent suppression with oral voriconazole. Fourteen months after the start of therapy, the patient had anterior dislocation of T2 thoracic vertebra with cord transection and quadriplegia. He was then treated intravenously with liquid itraconazole and interferon-gamma. The patient made a remarkable recovery over a 2-year period and was eventually able to walk independently. Thus, a combination of antifungals and interferon-gamma may have resulted in the positive outcome in this case.
Authors:
Jaffar A Al-Tawfiq; Hail M Al-Abdely
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Medical mycology     Volume:  48     ISSN:  1460-2709     ISO Abbreviation:  Med. Mycol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-06-22     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  9815835     Medline TA:  Med Mycol     Country:  England    
Other Details:
Languages:  eng     Pagination:  537-41     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antifungal Agents / therapeutic use*
Aspergillosis / diagnosis*,  microbiology,  pathology,  surgery
Aspergillus fumigatus / isolation & purification*
Cervical Vertebrae / microbiology*,  pathology
Drainage
Echinocandins / therapeutic use
Granulomatous Disease, Chronic / complications
Humans
Interferon-gamma / therapeutic use*
Itraconazole / therapeutic use
Male
Osteomyelitis / microbiology*,  pathology,  surgery
Pyrimidines / therapeutic use
Saudi Arabia
Thoracic Vertebrae / microbiology*,  pathology
Treatment Outcome
Triazoles / therapeutic use
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Echinocandins; 0/Pyrimidines; 0/Triazoles; 0/voriconazole; 304NUG5GF4/Itraconazole; 82115-62-6/Interferon-gamma; F0XDI6ZL63/caspofungin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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