Invasive aspergillosis in a user of inhaled cocaine: rhinosinusitis with bone and cartilage destruction

Azulay‐Abulafia, Luna; Sousa, Maria Auxiliadora Jeunon; Pussanti, Andrea; Coimbra, Daniel Dal’Asta; Vega, Hernando; Filho, Fred Bernardes

doi:10.1590/0037-8682-0086-2014

Cited by 8 publications

(8 citation statements)

References 9 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the patient illustrated here was otherwise mostly healthy, he likely acquired the infection through his maxillary tooth extraction, intranasal drug use, or a combination of both. In the literature, we identified five prior case reports of invasive aspergillosis occurring after a maxillary tooth extraction [2] , [11] , [12] , [13] , [14] , and two prior reports of A. flavus invasive sinusitis in the setting of intranasal cocaine use [5] , [15] . Cocaine is thought to cause vasoconstriction, mucosal inflammation, and changes to the mucociliary clearance mechanism that can subsequently lead to local ulceration, tissue ischemia, and tissue necrosis enabling Aspergillus to thrive in the decomposing organic material, especially in the setting of nasal moisture [5] , [15] , [21] .…”

Section: Discussionmentioning

confidence: 99%

“…Invasive fungal sinusitis is a dangerous form of infection by Aspergillus , with mortality rates as high as 80% [1] . Although invasive infection typically occurs in immunocompromised patients [2] , [3] , [4] , [5] , [6] , other risk factors include hot, dry climates [7] , [8] , [9] , [10] , farming occupations [3] , [8] , [11] , [12] , maxillary tooth extraction [2] , [11] , [12] , [13] , [14] , and intranasal cocaine use [5] , [15] . Diagnosis can be challenging as topical nasal cultures are often negative and symptoms often precede significant radiological findings [8] , [13] , [16] , [17] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Invasive Aspergillus flavus sinusitis in an immunocompetent patient using intranasal cocaine

Bougioukas

Campbell

Crooker

et al. 2021

IDCases

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Invasive Aspergillus flavus sinusitis in an immunocompetent patient using intranasal cocaine

Bougioukas

Campbell

Crooker

et al. 2021

IDCases

View full text Add to dashboard Cite

“…Septate hyphae that are seen microscopically are typical and specific for Aspergillus spp. [ 2 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Aspergillosis is the most common opportunistic fungal infection in humans, which usually affects the pulmonary tract but can also infect any organ, including the skin, bones, sinuses, cerebral meninges, myocardium, liver, thyroid, and renal tissues [ 1 ]. IA can cause serious complications related to high morbidity and mortality in humans, especially immunocompromised patients such as those with systemic lupus erythematosus (SLE) and chronic steroid users [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Invasive maxillary aspergillosis in a patient with systemic lupus erythematosus: Case report

Dachlan

Wicaksana

Fauzi

et al. 2020

Annals of Medicine and Surgery

View full text Add to dashboard Cite

Introduction Invasive aspergillosis (IA) is a fungal infection caused by Aspergillus species (spp.). Aspergillosis is the most common source of opportunistic fungal infection in humans. IA can cause serious complications related to high morbidity and mortality in immunocompromised patients. Presentation of case We report a case of a 22-year-old female with a chief complaint of having a hole in the roof of her mouth. She was diagnosed with SLE in 2009. She had been consuming oral methylprednisolone ever since. In 2018, she experienced worsened symptoms and was hospitalized. She experienced swelling and bleeding of her gums and some of her teeth becoming loose and falling out, and then developing a hole in the roof of her mouth. Subsequently, she was treated with oral cyclophosphamide, oral mycophenolate sodium, and oral fluconazole. She was asked to stop taking oral methylprednisolone. In 2019, the palate biopsy was performed and showed Aspergillus spp. invading the palate. Afterward, the patient was referred to our clinic for defect closure. The patient was operated on for debridement and reconstruction of the defect. There was no recurrence of the defect or complications observed in the follow-up. The patient was satisfied with the surgical results. Discussion IA is a destructive and potentially harmful opportunistic fungal infection and treatments with surgical interventions should be well-thought-out in immunocompromised patients. Conclusion The management of IA are controlling any underlying diseases and surgical debridement or necrotomy. Generally, antifungal therapy and prompt surgical intervention are successful in managing invasive aspergillosis.

show abstract

“…Andreia Matas [1] , Andreia Veiga [1] and João Paulo Gabriel [1] [1]. Serviço de Neurologia, Hospital de Vila Real, Centro Hospitalar Trás-os-Montes-e-Alto-Douro, Lordelo, Vila Real, Portugal.…”

Section: Tumoral Presentation Of Invasive Cerebral Aspergillosisunclassified

Tumoral presentation of invasive cerebral aspergillosis

Matas

Veiga

Gabriel

2015

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

A 79-year-old diabetic and hypertensive woman with no history of underlying systemic diseases or immunosuppressive therapy presented in our neurology department with complaints of mild cognitive dysfunction that had developed in the past 6 months. Examination showed mild cognitive impairment without other neurologic defi cits. The patient was afebrile, and her vital signs were stable. However, signs of periorbital infl ammation affecting her right eye were found.A computed tomography (CT) scan of the patient's brain revealed a large, isoattenuated right frontal mass with central hypoattenuated areas of necrosis ( Figure A). Brain magnetic resonance imaging (MRI) images showed that the mass had a complex appearance and extended to the roof and soft tissues of the orbita ( Figure B).No abnormalities were detected in the laboratory studies. Immunological test results were normal, and the patient's serum was negative for human immunodefi ciency virus (HIV) and tumor markers. A computed tomography scan of her chest, abdomen, and pelvis showed unremarkable results.A craniotomy and sub-total resection of the mass were performed. Histopathological fi ndings revealed an infl ammatory, granulomatous lesion with septate hyphae (Figure C). The cultures from the brain specimen yielded a positive result for Aspergillus sp.Concerning the probable route of infection, a pulmonary source and hematogenous route were excluded, but a contiguous spread by maxillary sinusitis could not be ruled out.Postoperatively, the patient was treated by systemic administration of voriconazole (4mg/kg intravenously, twice daily) and caspofungin (50mg intravenously, daily) to which she showed only a minimal response. The disease progressed, and the patient eventually died 2 months after the diagnosis.

show abstract

Invasive aspergillosis in a user of inhaled cocaine: rhinosinusitis with bone and cartilage destruction

Cited by 8 publications

References 9 publications

Invasive Aspergillus flavus sinusitis in an immunocompetent patient using intranasal cocaine

Invasive Aspergillus flavus sinusitis in an immunocompetent patient using intranasal cocaine

Invasive maxillary aspergillosis in a patient with systemic lupus erythematosus: Case report

Tumoral presentation of invasive cerebral aspergillosis

Contact Info

Product

Resources

About