Coexistence of fatal disseminated invasive aspergillosis and pyoderma gangrenosum: a case report.

Objective: To report an unusual case of disseminated aspergillosis involving the lymph nodes, lungs, and skin in a patient with pyoderma gangrenosum (PG) and myelodysplastic syndrome (MDS).Case Presentation and Intervention: A 46-year-old man presented with productive cough of 2 weeks' duration. Bes...

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Publicado en:Medical Principles & Practice Vol. 20; no. 4; pp. 380 - 384
Autores principales: Yang, Chien-Chang, Hsu, Po-Chang, Cheng, Chun-Wen, Lee, Ming-Hsun
Formato: case study research Journal Article
Publicado: Karger AG 2011
Acceso en línea:Ver este registro en EBSCOhost
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        10.1159/000324802
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        atl: Coexistence of fatal disseminated invasive aspergillosis and pyoderma gangrenosum: a case report.
      aug:
        au:
          Yang, Chien-Chang
          Hsu, Po-Chang
          Cheng, Chun-Wen
          Lee, Ming-Hsun
        affil: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
      sug:
        subj:
          Aspergillosis Complications
          Myelodysplastic Syndromes Complications
          Pyoderma Gangrenosum Complications
          Adrenal Cortex Hormones Adverse Effects
          Antifungal Agents Therapeutic Use
          Aspergillosis Diagnosis
          Aspergillosis Drug Therapy
          Aspergillosis Microbiology
          Peptides Therapeutic Use
          Fatal Outcome
          Male
          Middle Age
          Myelodysplastic Syndromes Diagnosis
          Myelodysplastic Syndromes Microbiology
          Myelodysplastic Syndromes Pathology
          Pyoderma Gangrenosum Diagnosis
          Pyoderma Gangrenosum Drug Therapy
          Pyoderma Gangrenosum Microbiology
          Middle Aged: 45-64 years
          Male
      ab: Objective: To report an unusual case of disseminated aspergillosis involving the lymph nodes, lungs, and skin in a patient with pyoderma gangrenosum (PG) and myelodysplastic syndrome (MDS).Case Presentation and Intervention: A 46-year-old man presented with productive cough of 2 weeks' duration. Besides, several painless, fixed lymph nodes were palpated at his left neck. He had PG and MDS diagnosed in June 2004 with regular use of oral dapsone and prednisolone. His skin lesions healed with scar formation and no purulent discharge. A computed tomography scan of the head, neck and chest showed bilateral lung consolidation and abscesses at the left neck, right upper lung and right pleura. The neck abscess culture grew Aspergillus species. Dark reddish macules developed over the right arm, chest and abdominal wall, and the left lower limb 2 weeks after initiation of amphotericin B. The histology of the right arm skin biopsy showed invasive aspergillosis. Caspofungin was started then for suspicion of poor response to amphotericin B. He expired despite 35 days of antifungal therapy.Conclusion: This report highlights the rarity of coexistence of disseminated aspergillosis and PG, and should alert physicians to the possibility of invasive fungal infection superimposed on a chronic skin lesion.
      pubtype: Academic Journal
      doctype:
        case study
        research
        Journal Article
      ougenre: Article
    language: English
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