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Vertebral osteomyelitis due to Aspergillus fumigatus in a patient with chronic granulomatous disease successfully treated with antifungal agents and interferon-gamma.
- Source :
-
Medical mycology [Med Mycol] 2010 May; Vol. 48 (3), pp. 537-41. - Publication Year :
- 2010
-
Abstract
- 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.
- Subjects :
- Adolescent
Aspergillosis microbiology
Aspergillosis pathology
Aspergillosis surgery
Caspofungin
Cervical Vertebrae pathology
Drainage
Echinocandins therapeutic use
Granulomatous Disease, Chronic complications
Humans
Itraconazole therapeutic use
Lipopeptides
Male
Osteomyelitis pathology
Osteomyelitis surgery
Pyrimidines therapeutic use
Saudi Arabia
Thoracic Vertebrae pathology
Treatment Outcome
Triazoles therapeutic use
Voriconazole
Antifungal Agents therapeutic use
Aspergillosis diagnosis
Aspergillus fumigatus isolation & purification
Cervical Vertebrae microbiology
Interferon-gamma therapeutic use
Osteomyelitis microbiology
Thoracic Vertebrae microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2709
- Volume :
- 48
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Medical mycology
- Publication Type :
- Academic Journal
- Accession number :
- 19886765
- Full Text :
- https://doi.org/10.3109/13693780903325290