[Disseminated Aspergillus siamensis infection following haploidentical bone marrow transplantation for chronic granulomatous disease].

[Disseminated Aspergillus siamensis infection following haploidentical bone marrow transplantation for chronic granulomatous disease].

Rinsho Ketsueki. 2020;61(4):327-333

Authors: Maemura R, Wakamatsu M, Sakaguchi H, Yoshida N, Karakawa S, Kobayashi M, Kamei K, Hama A

Abstract
An 18-year-old male patient who had been diagnosed with chronic granulomatous disease at 2 years old and suffering from repeated severe infections underwent human leukocyte antigen haploidentical bone marrow transplantation from his mother using reduced intensity conditioning. After engraftment, donor lymphocyte infusion was initiated to decrease donor chimerism on day 96. On day 120, acute graft-versus-host disease occurred; hence, steroid administration was initiated. On day 173, a generalized convulsion occurred; multiple abscesses were observed in the brain, lung, kidney, and prostate. Aspergillus siamensis of unknown pathogenic status was cultured in the abscess fluid from the brain, prostate, and kidney; accordingly, he was diagnosed with disseminated aspergillosis involving the brain, prostate, lungs, and kidney. Despite using a combination of various antifungal drugs, he died of multiple organ failure on day 239. Disseminated aspergillosis following the hematopoietic stem cell transplantation is a fatal complication. If infection symptoms are observed, the presence of any fungal antigens should be examined. Appropriate samples should be promptly collected, and adequate antifungal drugs should be administered based on the fungal species and drug sensitivity results.

PMID: 32378575 [PubMed – in process]

Source: Industry