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Aspergillus fumigatus Epidural Abscess in a Renal Transplant Recipient

Aspergillus fumigatus Epidural Abscess in a Renal Transplant Recipient Abstract An epidural abscess caused by Aspergillus fumigatus occurred in a recipient of a cadaveric, renal allograft. The patient had persistent back pain and a peripheral neuropathy that involved the lower extremities. Signs of spinal cord compression evolved. No definite portal of entry was found. Diagnosis was made by histologic examination and culture of a biopsy specimen. Therapy, consisting of aggressive surgical debridement, intravenous amphotericin B, and oral flucytosine was unsuccessful in eradicating the organism. At postmortem examination, Aspergillus was identified at the abscess site. To our knowledge, aspergillosis presenting as an epidural abscess in the immunosuppressed, renal transplant recipient has not previously been reported and should be considered in the differential diagnosis of back pain and peripheral neuropathy in such a patient. (Arch Intern Med 138:153-154, 1978) References 1. Young RC, Bennett JE, Bogel CL, et al: Aspergillosis: The spectrum of the disease in 98 patients . Medicine 49:147-173, 1970.Crossref 2. Burton JR, Zachery JB, Bessin R, et al: Aspergillosis in four renal transplant recipients . Ann Intern Med 77:383-388, 1972.Crossref 3. Meyer RD, Young LS, Armstrong D, et al: Aspergillosis complicating neoplastic disease . Am J Med 54:6-15, 1973.Crossref 4. Shaw FW, Warthen HJ: Aspergillosis of bone . South Med J 29:1070-1071, 1936.Crossref 5. Seres SL, Ono H, Benner EJ: Aspergillosis presenting as spinal cord compression . J Neurosurg 36:221-224, 1972.Crossref 6. Wybel RE: Mycosis of cervical spinal cord following intrathecal penicillin therapy . Arch Pathol 53:167-173, 1952. 7. Hughes WT: Generalized aspergillosis . Am J Dis Child 112:262-265, 1966.Crossref 8. Bach MC, Adler JL, Breman J, et al: Influence of rejection therapy on fungal and nocardial infections in renal-transplant recipients . Lancet 1:180-184, 1973.Crossref 9. Prystowsky SK, Vogelstein B, Ettinger DS, et al: Invasive aspergillosis . N Engl J Med 295:655-658, 1976.Crossref 10. Young RC, Bennett JE, Geelhoed GW, et al: Fungemia with compromised host resistance . Ann Intern Med 80:605-612, 1974.Crossref 11. Young RC, Bennett JE: Invasive aspergillosis: Absence of detectable antibody responses . Am Rev Respir Dis 104:710-716, 1971. 12. Kitahara M, Seth VK, Medoff G, et al: Activity of amphotericin B, 5-fluorocytosine and rifampin against six clinical isolates of Aspergillus . Antimicrob Agents Chemother 9:915-919, 1976.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Aspergillus fumigatus Epidural Abscess in a Renal Transplant Recipient

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1978.03630250105029
Publisher site
See Article on Publisher Site

Abstract

Abstract An epidural abscess caused by Aspergillus fumigatus occurred in a recipient of a cadaveric, renal allograft. The patient had persistent back pain and a peripheral neuropathy that involved the lower extremities. Signs of spinal cord compression evolved. No definite portal of entry was found. Diagnosis was made by histologic examination and culture of a biopsy specimen. Therapy, consisting of aggressive surgical debridement, intravenous amphotericin B, and oral flucytosine was unsuccessful in eradicating the organism. At postmortem examination, Aspergillus was identified at the abscess site. To our knowledge, aspergillosis presenting as an epidural abscess in the immunosuppressed, renal transplant recipient has not previously been reported and should be considered in the differential diagnosis of back pain and peripheral neuropathy in such a patient. (Arch Intern Med 138:153-154, 1978) References 1. Young RC, Bennett JE, Bogel CL, et al: Aspergillosis: The spectrum of the disease in 98 patients . Medicine 49:147-173, 1970.Crossref 2. Burton JR, Zachery JB, Bessin R, et al: Aspergillosis in four renal transplant recipients . Ann Intern Med 77:383-388, 1972.Crossref 3. Meyer RD, Young LS, Armstrong D, et al: Aspergillosis complicating neoplastic disease . Am J Med 54:6-15, 1973.Crossref 4. Shaw FW, Warthen HJ: Aspergillosis of bone . South Med J 29:1070-1071, 1936.Crossref 5. Seres SL, Ono H, Benner EJ: Aspergillosis presenting as spinal cord compression . J Neurosurg 36:221-224, 1972.Crossref 6. Wybel RE: Mycosis of cervical spinal cord following intrathecal penicillin therapy . Arch Pathol 53:167-173, 1952. 7. Hughes WT: Generalized aspergillosis . Am J Dis Child 112:262-265, 1966.Crossref 8. Bach MC, Adler JL, Breman J, et al: Influence of rejection therapy on fungal and nocardial infections in renal-transplant recipients . Lancet 1:180-184, 1973.Crossref 9. Prystowsky SK, Vogelstein B, Ettinger DS, et al: Invasive aspergillosis . N Engl J Med 295:655-658, 1976.Crossref 10. Young RC, Bennett JE, Geelhoed GW, et al: Fungemia with compromised host resistance . Ann Intern Med 80:605-612, 1974.Crossref 11. Young RC, Bennett JE: Invasive aspergillosis: Absence of detectable antibody responses . Am Rev Respir Dis 104:710-716, 1971. 12. Kitahara M, Seth VK, Medoff G, et al: Activity of amphotericin B, 5-fluorocytosine and rifampin against six clinical isolates of Aspergillus . Antimicrob Agents Chemother 9:915-919, 1976.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1978

References