Small-Bowel Infarction From Disseminated Aspergillosis

Abstract

This diagnosis should be considered when neutropenic patients show abdominal pain and distention with fever. Repetition of Aspergillus antigenemia, search for others aspergillosis localizations, CT scan, and colonoscopy with biopsies should be performed until diagnosis allows the administration of early antifungal therapy.

Disseminated aspergillosis causing intestinal failure following colectomy for perforated colitis

“…It is rapidly progressive with reported mortality rates of 80–90% 2 3. A detailed medical, drug and travel history is therefore paramount in cases of critically unwell patients in whom the pathogenesis is unusually aggressive.…”

“…Of those with invasive disease, 41–47% will have involvement of the gastrointestinal tract 2. These patients may develop bowel obstruction and other complications including intestinal ischaemia, bleeding, necrosis and perforation 3. However, diagnosis of gastrointestinal aspergillosis is difficult.…”

Localized small-bowel infarction caused by Aspergillus during chemotherapy for acute myeloid leukemia: Report of a case

“…5 The main localizations of aspergillosis are the lung and cranial sinuses, with secondary dissemination to the brain, gastrointestinal tract, liver, and heart. 5 According to one report, the gastrointestinal tract was the site of 41% of deep fungal infections in immunocompromised patients, with 22% affecting the lower part of the gastrointestinal tract.…”

“…Bronchoalveolar lavage fl uid should also be tested for aspergillosis because gastrointestinal invasive aspergillosis is usually part of a disseminated disease with lung involvement. 5,7 However, the fi nal diagnosis is most often established by the pathologic fi ndings of a surgically resected specimen.…”

Isolated enteric aspergillosis in a non severely immunocompromised patient. Case report and literature review

“…Similarly, Schwesinger et al reported that 25 of 27 patients with aspergillosis had pulmonary involvement [6]. Disseminated aspergillosis can cause bowel infarction or diffuse peritonitis due to small bowel perforation [7][8][9][10]. Moreover, the majority of these patients succumbed within a short time [11].…”