Soft Tissue Abscess Caused by Aspergillus Fumigatus in an Immunosuppressive Patient

Abstract

Aspergillosis is a definition including a wide variety of diseases caused by fungi in the genus Aspergillus. Aspergillosis that occurs especially in neutropenic and immunosuppressive patient is an opportunistic infection with a very high mortality rate. In this study, we presented a case of primary cutaneous aspergillosis that caused in a heart transplant recipient. Thirty-nine-years-old male patient with the complaints of high fever lasting for ten days, redness of the right thigh, swelling, and pain, was admitted to our hospital. By the tissue ultrasonography of right thigh, 3x12 cm in size of septated intensive fluid collection (abscess?) in muscle tissue at a depth of 1.5 cm to the skin surface was reported. The biopsy specimens that were taken from the lesion sent to microbiology and pathology laboratories. The branching septate hyphae were observed in Hematoxylin-Eosin and Gram stained preparations. Aspergillus fumigatus was isolated and identified from the biopsy specimen. The patient\'s symptoms were regressed rapidly and the lesion was improved by surgical debridement and antifungal agent (amphotericin B) therapy. In the light of this case report, we were emphasized that microbiologic examination and culture have an important role for diagnosis of cutaneous aspergillosis.

Keywords

• Aspergillosis, cutaneous, Aspergillus fumigatus, immunosuppressive, heart transplant

Soft Tissue Abscess Caused by Aspergillus Fumigatus in an Immunosuppressive Patient

Öz

Asperjiloz; Aspergillus genusunda yer alan mantarların meydana getirdiği çok geniş hastalıkları kapsayan bir tanımdır. Özellikle nötropenik ve immünsüpresif hastalarda gelişen aspergillozis çok yüksek mortalite oranına sahip fırsatçı bir enfeksiyondur. Bu makalede kalp nakli yapılan bir hastada meydana gelen primer kütanöz aspergillozis olgusunu sunduk. On günden uzun süren yüksek ateş, sağ uyluğunda şişlik, kızarıklık ve ağrı şikayetleri olan otuz dokuz yaşındaki erkek hasta hastanemize başvurdu. Sağ uyluk ultrasonografi incelemesinde; deri yüzeyinden 1.5 cm derinde kas dokusu içerisinde 3x12 cm boyutlarında septalı yoğun sıvı birikimi (abse?) rapor edildi. Lezyondan alınan biyopsi materyalleri mikrobiyoloji ve patoloji laboratuvarlarına gönderildi. Hematoksilen-Eozin ve Gram boyalı preparatlarda dallanmış septalı hifler görüldü. Biyopsi materyalinden Aspergillus fumigatus izole ve identifiye edildi. Cerrahi olarak debride edilen ve amfoterisin B tedavisi başlanan hastanın semptomları hızla geriledi ve lezyonları iyileşti. Bu olgu sunumunun ışığında; aspergillozisin tanısında mikrobiyolojik inceleme ve kültürün önemli bir role sahip olduğunu vurguladık

Anahtar Kelimeler

• Asperjiloz, kütanöz, Aspergillus fumigatus, immünsüpresif, kalp nakli

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