Disseminated <i>Aspergillus siamensis</i> infection following haploidentical bone marrow transplantation for chronic granulomatous disease

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  • MAEMURA Ryo
    Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital
  • WAKAMATSU Manabu
    Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital
  • SAKAGUCHI Hirotoshi
    Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital
  • YOSHIDA Nao
    Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital
  • KARAKAWA Shuhei
    Department of Pediatrics, Hiroshima University Graduate School of Biomedical & Health Sciences
  • KOBAYASHI Masao
    Department of Pediatrics, Hiroshima University Graduate School of Biomedical & Health Sciences
  • KAMEI Katsuhiko
    Division of Clinical Research, Medical Mycology Research Center, Chiba University
  • HAMA Asahito
    Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital

Bibliographic Information

Other Title
  • 慢性肉芽腫症に対するHLA半合致骨髄移植後に発症した播種性<i>Aspergillus siamensis</i>症
  • 症例報告 慢性肉芽腫症に対するHLA半合致骨髄移植後に発症した播種性Aspergillus siamensis症
  • ショウレイ ホウコク マンセイ ニクゲシュショウ ニ タイスル HLA ハンガッチ コツズイ イショク ゴ ニ ハッショウ シタ ハシュセイ Aspergillus siamensisショウ

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Abstract

<p>An 18-year-old male patient who had been diagnosed with chronic granulomatous disease at 2 years old and suffering from repeated severe infections underwent human leukocyte antigen haploidentical bone marrow transplantation from his mother using reduced intensity conditioning. After engraftment, donor lymphocyte infusion was initiated to decrease donor chimerism on day 96. On day 120, acute graft-versus-host disease occurred; hence, steroid administration was initiated. On day 173, a generalized convulsion occurred; multiple abscesses were observed in the brain, lung, kidney, and prostate. Aspergillus siamensis of unknown pathogenic status was cultured in the abscess fluid from the brain, prostate, and kidney; accordingly, he was diagnosed with disseminated aspergillosis involving the brain, prostate, lungs, and kidney. Despite using a combination of various antifungal drugs, he died of multiple organ failure on day 239. Disseminated aspergillosis following the hematopoietic stem cell transplantation is a fatal complication. If infection symptoms are observed, the presence of any fungal antigens should be examined. Appropriate samples should be promptly collected, and adequate antifungal drugs should be administered based on the fungal species and drug sensitivity results.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 61 (4), 327-333, 2020

    The Japanese Society of Hematology

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