invasive pulmonary aspergillosis in patients with non-decompensated liver cirrhosis: a case report

نویسندگان

roya ghasemian antimicrobial resistance research center, mazandaran university of medical sciences, sari, ir iran

anahita nosrati department of pathology, gastrointestinal cancer register center, imam khomeini hospital, mazandaran university of medical sciences, sari, ir iran

mojtaba nabili student research committee, mazandaran university of medical sciences, sari, ir iran

tahereh shokohi department of medical mycology and parasitology/invasive fungi research center, school of medicine, mazandaran university of medical sciences, sari, ir iran; department of medical mycology and parasitology/invasive fungi research center, school of medicine, mazandaran university of medical sciences, sari, ir iran. tel: +98-1133543781, fax: +98-1133543248

چکیده

conclusions in patients with liver cirrhosis, when there is evidence of severe pulmonary disease without proper response to treatment, the possibility of invasive pulmonary fungal infection should be considered. introduction invasive pulmonary aspergillosis (ipa) is a fatal disease usually occurring in patients with neutropenia resulted from chemotherapy for malignancy. the other risk factors include consuming corticosteroids, organ transplant and advanced acquired immunodeficiency syndrome (aids). recently, the incidence of ipa in immunocompetent patients without any history of organ transplant or malignancy has been increasing. patients with advanced cirrhosis are one of the cases involved in this infection. case presentation in this case study, we report invasive pulmonary aspergillosis in a 50-year-old patient (from sari, iran), who had gradual abdominal pain and ascites, cough and respiratory distress. radiographic signs showed a round infiltration in the upper part of the right lung. despite receiving 48-hour antibiotics therapy, the fever had not subsided. in ct-guided needle lung biopsy, septate and acutely angled hyphae (dichotomous) were seen. in ct-guided needle lung biopsy, septate and acutely angled hyphae (dichotomous) were seen. direct examination of the sputum showed septate hyphae compatible with a filamentous fungus. according to morphological and molecular characterization, aspergillus fumigatus was confirmed. minimum inhibitory concentration (mic) values of antifungal agents were determined based on the clinical and laboratory standard institute (clsi) m38-a2. treatment with intravenous amphotericin b was changed to oral voriconazole 200 mg, twice a day. the patient did not have any kind of residual lung lesion within the six-month follow-up and the cirrhosis was under control and she currently has no respiratory symptoms or signs.

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عنوان ژورنال:
archives of clinical infectious diseases

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