Invasive maxillary aspergillosis in a patient with systemic lupus erythematosus: Case report

Autor: Siti Isya Wahdini, Aditya Wicaksana, Muhammad Rosadi Seswandhana, Ishandono Dachlan, Aditya Rifqi Fauzi, Franciscus Wihan Pradana, Muhammad Bakhrul Lutfianto, Nurardhilah Vityadewi
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Surgical results
medicine.medical_specialty
Palate biopsy
medicine.medical_treatment
Case Report
ENT
ear
nose
and throat

Aspergillosis
GMS
Grocott-Gomori's Methenamine Silver

SLE
systemic lupus erythematosus

03 medical and health sciences
High morbidity
CT scan
computed tomography

0302 clinical medicine
Systemic lupus erythematosus
medicine
Plastic reconstructive surgery
ANA
antinuclear antibodies

Palatal defect
Debridement
business.industry
Surgical debridement
IA
Invasive aspergillosis

anti-dsDNA
anti-double stranded DNA

General Medicine
FRS
fungal rhinosinusitis

medicine.disease
PAS
Periodic Acid-Schiff

Surgery
030220 oncology & carcinogenesis
Maxillary defect
Invasive aspergillosis
030211 gastroenterology & hepatology
business
Oral cyclophosphamide
MRI
magnetic resonance imaging

Fluconazole
medicine.drug
Zdroj: Annals of Medicine and Surgery
ISSN: 2049-0801
Popis: Introduction Invasive aspergillosis (IA) is a fungal infection caused by Aspergillus species (spp.). Aspergillosis is the most common source of opportunistic fungal infection in humans. IA can cause serious complications related to high morbidity and mortality in immunocompromised patients. Presentation of case We report a case of a 22-year-old female with a chief complaint of having a hole in the roof of her mouth. She was diagnosed with SLE in 2009. She had been consuming oral methylprednisolone ever since. In 2018, she experienced worsened symptoms and was hospitalized. She experienced swelling and bleeding of her gums and some of her teeth becoming loose and falling out, and then developing a hole in the roof of her mouth. Subsequently, she was treated with oral cyclophosphamide, oral mycophenolate sodium, and oral fluconazole. She was asked to stop taking oral methylprednisolone. In 2019, the palate biopsy was performed and showed Aspergillus spp. invading the palate. Afterward, the patient was referred to our clinic for defect closure. The patient was operated on for debridement and reconstruction of the defect. There was no recurrence of the defect or complications observed in the follow-up. The patient was satisfied with the surgical results. Discussion IA is a destructive and potentially harmful opportunistic fungal infection and treatments with surgical interventions should be well-thought-out in immunocompromised patients. Conclusion The management of IA are controlling any underlying diseases and surgical debridement or necrotomy. Generally, antifungal therapy and prompt surgical intervention are successful in managing invasive aspergillosis.
Highlights • IA can cause serious complications, especially immunocompromised patients. • The management can vary from pharmacological therapy to surgical intervention. • Antifungal therapy and prompt surgical intervention are successful in managing invasive aspergillosis.
Databáze: OpenAIRE