Acute isolated appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia

Nunzia Decembrino, Marco Zecca, Anna M aria Tortorano, Francesca Mangione, Fabiola Lallitto, Francesca Introzzi, Elena Bergami, Piero Marone, Francesca Tamarozzi, Caterina Cavanna

Research output: Contribution to journalArticle

Abstract

We describe a case of isolated acute appendicitis due to Aspergillus carneus in a neutropenic child with acute myeloid leukemia (AML) treated according to the AIEOP AML 2002/01 protocol. Despite prophylaxis with acyclovir, ciprofloxacin and fluconazole administered during the neutropenic phase, 16 days after the end of chemotherapy the child developed fever without identified infective foci, which prompted a therapy shift to meropenem and liposomial amphotericin B. After five days of persisting fever he developed ingravescent abdominal lower right quadrant pain. Abdominal ultrasound was consistent with acute appendicitis and he underwent appendectomy with prompt defervescence. PAS+ fungal elements were found at histopathology examination of the resected vermiform appendix, and galactomannan was low positive. A. carneus, a rare species of Aspergillus formerly placed in section Flavipedes and recently considered a member of section Terrei, was identified in the specimen. Treatment with voriconazole was promptly started with success. No other site of Aspergillus localization was detected. Appendicitis is rarely caused by fungal organisms and isolated intestinal aspergillosis without pulmonary infection is unusual. To our knowledge, this is the first report of infection due to A. carneus in a child and in a primary gastrointestinal infection.

Original languageEnglish
Pages (from-to)65-69
Number of pages5
JournalNew Microbiologica
Volume39
Issue number1
Publication statusPublished - Jan 1 2016

Keywords

  • Appendicitis
  • Aspergillus carneus
  • Galactomannan
  • Leukemia
  • Voriconazole

ASJC Scopus subject areas

  • Medicine(all)

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