Catastrophic Brain Aspergillosis after Liver Transplantation
Background. Liver transplantation has many complications. Because of receiving immunosuppressive regimens, infectious complications in these patients may have fatal results. Aspergillosis in solid organ recipients is one of the most common fungal infections that usually occur 1 month after transplan...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2021/8626057 |
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| author | Mohammadmahdi Abbasi Shirin Shams Ardakani Nasir Fakhar Hamid Eshaghi Hosein Alimadadi Toktam Faghihi Behdad Gharib Meisam Sharifzadeh Masoomeh Safaei |
| author_facet | Mohammadmahdi Abbasi Shirin Shams Ardakani Nasir Fakhar Hamid Eshaghi Hosein Alimadadi Toktam Faghihi Behdad Gharib Meisam Sharifzadeh Masoomeh Safaei |
| author_sort | Mohammadmahdi Abbasi |
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| description | Background. Liver transplantation has many complications. Because of receiving immunosuppressive regimens, infectious complications in these patients may have fatal results. Aspergillosis in solid organ recipients is one of the most common fungal infections that usually occur 1 month after transplantation. Aspergillus infection mainly involves the lungs. Although the central nervous system may get involved due to hematogenous spreading from lungs, isolated central nervous system involvement is rarely reported. Case Presentation. The patient was an 8-year-old boy, with a case of Wilson disease, who underwent liver transplantation due to acute fulminant hepatic failure. Four days after the surgery, he was affected by fever, agitation, loss of consciousness, hemiparesis, and focal seizure. Brain MRI showed abscess formation, whereas chest X-ray was normal. Intravenous antibiotics were initiated but the patient’s condition was not improving; therefore, surgical drainage of the abscess was performed. The pathological investigation was compatible with aspergillosis. Antifungal therapy with voriconazole was administrated. His symptoms were resolved but unfortunately, brain lesions caused persistent vegetative state. Discussion. Aspergillus is a ubiquitous organism that mainly occurs in immunocompromised patients. Aspergillosis could be prevented by environmental modification such as installing high-efficiency particulate air filters. Chemoprevention with triazoles, echinocandins, and polyenes is also effective. Voriconazole is the drug of choice for aspergillosis treatment. Although voriconazole is a highly effective antifungal drug, cerebral aspergillosis is often fatal. |
| format | Article |
| id | doaj-art-07460d502bec4d8294b53d7b4d90fcea |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-07460d502bec4d8294b53d7b4d90fcea2025-02-03T00:58:50ZengWileyCase Reports in Transplantation2090-69432090-69512021-01-01202110.1155/2021/86260578626057Catastrophic Brain Aspergillosis after Liver TransplantationMohammadmahdi Abbasi0Shirin Shams Ardakani1Nasir Fakhar2Hamid Eshaghi3Hosein Alimadadi4Toktam Faghihi5Behdad Gharib6Meisam Sharifzadeh7Masoomeh Safaei8Department of Pediatrics, Children‘s Mediacal Center, Tehran University of medical Sciences, Teran, IranDepartment of Pediatrics, Children‘s Mediacal Center, Tehran University of medical Sciences, Teran, IranDivision of Liver Transplantation, Imam Khomeini Hospital, TUMS, Teran, IranDepartment of Pediatric Infectious Disease, Children‘s Medical Center, TUMS, Teran, IranDepartment of Pediatrics, Tehran University of medical Sciences, Teran, IranDepartment of Clinical Pharmacy, Children s Medical Center, TUMS, Teran, IranDivision of Pediatric Critical Care, Children‘s Medical Center, TUMS, Teran, IranPediatrician, Assistant professor of pediatric Intensive care, Division of pediatric critical care, Children medical center, Tehran University of medical science, IranDepartment of pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran university of Medical Siences, Teran, IranBackground. Liver transplantation has many complications. Because of receiving immunosuppressive regimens, infectious complications in these patients may have fatal results. Aspergillosis in solid organ recipients is one of the most common fungal infections that usually occur 1 month after transplantation. Aspergillus infection mainly involves the lungs. Although the central nervous system may get involved due to hematogenous spreading from lungs, isolated central nervous system involvement is rarely reported. Case Presentation. The patient was an 8-year-old boy, with a case of Wilson disease, who underwent liver transplantation due to acute fulminant hepatic failure. Four days after the surgery, he was affected by fever, agitation, loss of consciousness, hemiparesis, and focal seizure. Brain MRI showed abscess formation, whereas chest X-ray was normal. Intravenous antibiotics were initiated but the patient’s condition was not improving; therefore, surgical drainage of the abscess was performed. The pathological investigation was compatible with aspergillosis. Antifungal therapy with voriconazole was administrated. His symptoms were resolved but unfortunately, brain lesions caused persistent vegetative state. Discussion. Aspergillus is a ubiquitous organism that mainly occurs in immunocompromised patients. Aspergillosis could be prevented by environmental modification such as installing high-efficiency particulate air filters. Chemoprevention with triazoles, echinocandins, and polyenes is also effective. Voriconazole is the drug of choice for aspergillosis treatment. Although voriconazole is a highly effective antifungal drug, cerebral aspergillosis is often fatal.http://dx.doi.org/10.1155/2021/8626057 |
| spellingShingle | Mohammadmahdi Abbasi Shirin Shams Ardakani Nasir Fakhar Hamid Eshaghi Hosein Alimadadi Toktam Faghihi Behdad Gharib Meisam Sharifzadeh Masoomeh Safaei Catastrophic Brain Aspergillosis after Liver Transplantation Case Reports in Transplantation |
| title | Catastrophic Brain Aspergillosis after Liver Transplantation |
| title_full | Catastrophic Brain Aspergillosis after Liver Transplantation |
| title_fullStr | Catastrophic Brain Aspergillosis after Liver Transplantation |
| title_full_unstemmed | Catastrophic Brain Aspergillosis after Liver Transplantation |
| title_short | Catastrophic Brain Aspergillosis after Liver Transplantation |
| title_sort | catastrophic brain aspergillosis after liver transplantation |
| url | http://dx.doi.org/10.1155/2021/8626057 |
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