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A Case of Fungal Sepsis Due to Aspergillus Spondylitis Followed by Cytomegalovirus Infection in a Renal Transplant Recipient

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Author(s)
S.B. ParkM.J. KangE.A. WhangS.Y. HanH.C. Kim
Keimyung Author(s)
Park, Sung BaeHwang, Eun AhHan, Seung YeupKim, Hyun Chul
Department
Dept. of Internal Medicine (내과학)
Journal Title
Transplantation Proceeding
Issued Date
2004
Volume
36
Issue
7
Abstract
Although advances in immunosuppressive therapy have led to increased survival of renal
transplant recipients, there are greater risks of developing infectious complications.
Because of its rarity and the lack of medical awareness, aspergillus spondylitis is often
misdiagnosed as tuberculous spondylitis, especially in its early stages. We report a case of
aspergillus spondylitis in a renal transplant followed by cytomegalovirus (CMV) retinitis.
Case. A 59-year-old woman was admitted due to general weakness and abdominal
discomfort. She had undergone renal transplantation 3 years previously. One month
before admission, she was diagnosed with CMV retinitis and treated with IV ganciclovir.
On admission, she suffered from lower abdominal pain. Colonoscopy revealed multiple
circular or patchy ulcers with surrounding severe mucosal edema in the sigmoid colon
findings consistent with intestinal tuberculosis. On hospital day 30, she complained of
lower extremity paresthesia and weakness. An MRI of the spine revealed a well-
demarcated paraspinal mass around the L2–4 body; tuberculous spondylitis was initially
considered. But despite antituberculosis medication, the patient progressed to spastic
paraparesis and sensory changes in both lower legs, requiring urgent surgical decompres-
sion. At hospital day 60, she suffered persistent fever and developed thrombocytopenia.
Wound discharge continued and paraparesis became denser. A CT of the spine showed
progression of the paraspinal abscess from the L2 body to the iliac crest. CT-guided psoas
muscle drainage was performed. Fungal culture showed Aspergillus species. Despite
antifungal therapy, the patient died after a prolonged hospital stay due to fungal sepsis and
septic shock from aspergillosis.
Keimyung Author(s)(Kor)
박성배
황은아
한승엽
김현철
Publisher
School of Medicine
Citation
S.B. Park et al. (2004). A Case of Fungal Sepsis Due to Aspergillus Spondylitis Followed by Cytomegalovirus Infection in a Renal Transplant Recipient. Transplantation Proceeding, 36(7), 2154–2155. doi: 10.1016/j.transproceed.2004.08.049
Type
Article
ISSN
0041-1345
Source
https://www.sciencedirect.com/science/article/pii/S0041134504009194?via%3Dihub
DOI
10.1016/j.transproceed.2004.08.049
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34712
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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