A RARE CASE OF ASPERGILLUS FUNGEMIA

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: Aspergillus species is a flagellated fungal organism known to cause tissue invasion and infection in immunocompromised individuals. fungemia an uncommon manifestation of described only case reports, with risk factors including neutropenia post-cardiac surgery. We describe aspergillus patient on immunosuppression for kidney transplant. CASE PRESENTATION: A 60-year-old female history polycystic disease requiring transplantation chronic tacrolimus presented the hospital shortness breath difficult-to-expectorate cough 2-3 weeks that did not improve outpatient antibiotic systemic steroid therapy. Physical examination was notable scattered rhonchi auscultation lung bases, laboratory work-up unremarkable. radiography left basilar infiltrate. Computed tomography (CT) chest revealed subsegmental atelectasis lower lobe, few pulmonary nodules, granulomas, but no active alveolar The placed empiric piperacillin/tazobactam some improvement symptoms. Blood cultures grew species, started isavuconazole. repeat CT performed, which showed solid central pneumonic infiltrate lobe surrounding nodularity, consistent aspergillosis. She transitioned oral regimen isovuconazole several discharge, improved her Subsequent imaging setting resolution nodularity. DISCUSSION: Invasive Aspergillosis severe form high mortality rate, seen primarily population. as result invasive aspergillosis rare complication unknown clinical significance. estimated incidence 12 34 infections per million patients, one retrospective analysis discovering 10.1% patients already-diagnosed Earlier studies have suggested that, while rare, presence does portend poorer prognosis, confirmed our patient's given prompt response standard antifungal CONCLUSIONS: Although represents potential sequelae dictate change management or prognosis. REFERENCE #1: Girmenia C, Nucci M, Martino P. Clinical significance fungaemia haematological malignancies Br J Haematol. 2001 Jul;114(1):93-8. doi: 10.1046/j.1365-2141.2001.02901.x. PMID: 11472350. DISCLOSURES: No relevant relationships by Asim Amjad, source=Web Response Dan Kazmierski, Si Li, jacob miller, Pius Ochieng, NISHANT SHARMA,