Methylprednisolone
- PDF / 154,139 Bytes
- 1 Pages / 623.591 x 841.847 pts Page_size
- 61 Downloads / 169 Views
1
S
Ulcerative Aspergillus tracheobronchitis: case report A 54-year-old female stem cell transplant recipient developed ulcerative Aspergillus tracheobronchitis during treatment with methylprednisolone [dosage not stated]. The woman, who was diagnosed with myelodysplastic syndrome and had undergone stem cell transplant 6 months earlier, was hospitalised with a 3-day history of painful and pruritic rash on her limbs, back and face. A skin biopsy confirmed stage II graft-versus-host disease and she started receiving methylprednisolone and tacrolimus. She also received micafungin for fungal prophylaxis. She had a normal chest x-ray and increased liver enzyme levels, thrombocytopenia and anaemia. After 1 week in hospital, she developed cough. A chest x-ray and a CT scan revealed a new left lower lobe consolidation and a right upper lobe nodular density. The woman started receiving broad-spectrum antibacterials for bacterial pneumonia and voriconazole for presumed invasive aspergillosis. She received platelet transfusion. A bronchoscopy showed multiple shallow, dusky ulcers, measuring about 0.5cm, throughout her tracheobronchial tree. Left lower lobe biopsy findings revealed poorly preserved fungal hyphae in the tissue. The tracheal biopsy findings demonstrated fungal colonies, suggestive of Aspergillus and invasive fungal hyphae. Presence of Aspergillus species was confirmed by bronchoalveolar lavage cultures. She continued to received voriconazole and was discharged without complications. Author comment: "Our patient’s risk factors for invasive [Aspergillus] may have been [graft-versus-host disease] and corticosteroid use." Moghekar AR, et al. Ulcerative aspergillus tracheobronchitis in a stem cell transplant patient. 2008 Annual Meeting of the American College of Chest 801133422 Physicians : abstr. 54002S, 29 Oct 2008. - USA
0114-9954/10/1232-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 13 Dec 2008 No. 1232
Data Loading...
