Common Colonizer at Uncommon Site

Author:

Rucha Karad, Bibhuti Saha, Soumendranath Haldar

Author address:

Department of Infectious Diseases and Advanced Microbiology, School of Tropical Medicine, Kolkata (IN

Abstract:

Objectives: Aspergillus got its name from the resemblance of its asexual spore-forming structure to the aspergillum. Infections are typically caused by Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger and Aspergillus terreus. Extrapulmonary invasive aspergillosis occurs in patients who are severely immunocompromised. Organs involved included heart, kidney, central nervous system, gastrointestinal tract, spleen, liver, thyroid gland and pancreas and its often fatal if not diagnose early.
Methods and Results: Here in this study of extrapulmonary aspergillosis we have included total 9(5 female, 4 male) cases which we have seen in-between year September 2020- December 2022. In our study we have seen one CNS, one splenic, one spinal, one bone marrow involvement, four sinonasal and one invasive skin lesion with aspergillus species. Four of our patients are immunocompetent while among other five patients, one has rheumatoid arthritis on DMARDs, one was recently diagnosed as MDS and one has cardiac comorbidity, one has breast cancer post mastectomy on chemotherapy, and one patient has chronic hepatitis B infection. In all the patients tissue invasion with aspergillus was demonstrated, serum biomarkers were elevated in all and culture was positive in all the cases. Predominant species in our study is A. fumigatus (total 5 isolates) followed by A.niger (2 isolates) and 2 case of A. flavus. All patients were treated with voriconazole, one fatality was noted (patient with myelodysplastic syndrome) while other were improved significantly.
Conclusion: Invasive extrapulmonary aspergillosis is rare entity which is difficult to diagnose as there is always confusion between infection and contamination. Most of the cases falsely diagnosed as other aetiologies because suspicion at extrapulmonary site is often ignored and hence the treatment initiation was delayed. More vigilance should be there while diagnosing extrapulmonary Aspergillosis

Abstract Number: 15

Conference Year: 2024

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