Necrotizing encephalitis caused by disseminated Aspergillus infection after orthotopic liver transplantation

Case Reports in Gastroenterology
Luis E Barrera-HerreraRocio Lopez

Abstract

Liver transplantation is the only available treatment for some patients with end-stage liver disease. Despite reduction in mortality rates due to advances related to surgical techniques, intensive medical management and immunosuppressive therapy, invasive fungal infections remain a serious complication in orthotopic liver transplantation. We report the case of an 18-year-old male diagnosed with autoimmune cirrhosis in 2009 who was assessed and listed for liver transplantation for massive variceal hemorrhage. One year after listing a successful orthotopic liver transplantation was performed. Uneventful early recovery was achieved; however, he developed pulmonary and neurological Aspergillus infection 23 and 40 days after surgery, respectively. Antibiotic therapy with voriconazole and amphotericin was started early, with no major response. Neuroimaging revealed multiple right frontal and right parietal lesions with perilesional edema; surgical management of the brain abscesses was performed. A biopsy with periodic acid-Schiff and Gomori stains revealed areas with mycotic microorganisms morphologically consistent with Aspergillus, later confirmed by culture. The patient developed necrotizing encephalitis secondary to aspergillosis...Continue Reading

Citations

Mar 4, 2021·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Akira A ShishidoJohn W Baddley

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Methods Mentioned

BETA
biopsy
bronchoalveolar lavage

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