Title |
Embolizing pulmonary aspergillosis, mycobacterial & aspergillous splenic abscess and cytomegalovirus co-infection following steroid induced immunosuppression: a case report
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Published in |
BMC Infectious Diseases, August 2018
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DOI | 10.1186/s12879-018-3293-4 |
Pubmed ID | |
Authors |
Harsha Anuruddhika Dissanayake, Praveen Nilendra Weeratunga, Panduka Karunanayake, Rushika D. Lanerolle, M. V. Chandu de Silva, Saroj Jayasinghe |
Abstract |
Aspergillosis is a serious infection particularly affecting the immunodeficient host. Its co-infection with tuberculosis and cytomegalovirus has not been reported before. Embolic events are well recognized with aspergillous endocarditis and aortitis. Splenic abscess is a rare serious complication of disseminated aspergillosis and is difficult to treat. We report the first case of multiple embolic events and splenic abscess in a patient with pulmonary aspergillosis and cytomegaloviral and tuberculous co-infection, without endocarditis or aortitis. Thirty-year-old male presented with fever and non-productive cough while on glucocorticoids for glomerulonephritis. He was found to have pulmonary aspergillosis and subsequently developed bilateral lower limb and cerebral fungal emboli and fungal abscess in the spleen. He had IgM and B cell deficiency and cytomegalovirus (CMV) and tuberculous co-infections. He recovered after prolonged course of antimicrobials, splenectomy and cessation of glucocorticoid therapy which also lead to the resolution of immune deficiencies. This report illustrates rare combination of B and T cell suppressive effects of glucocorticoids leading to co-infections with CMV, Mycobacterium tuberculosis and Aspergillus and systemic fungal embolization from pulmonary aspergillosis. |
X Demographics
Geographical breakdown
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United Kingdom | 1 | 50% |
Unknown | 1 | 50% |
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Type | Count | As % |
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Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 23 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 3 | 13% |
Researcher | 3 | 13% |
Other | 2 | 9% |
Professor | 2 | 9% |
Student > Ph. D. Student | 2 | 9% |
Other | 3 | 13% |
Unknown | 8 | 35% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 8 | 35% |
Veterinary Science and Veterinary Medicine | 1 | 4% |
Biochemistry, Genetics and Molecular Biology | 1 | 4% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 4% |
Immunology and Microbiology | 1 | 4% |
Other | 1 | 4% |
Unknown | 10 | 43% |