Disseminated cerebral aspergillosis complicated by thrombotic microangiopathy

Robynn Lester; Deirdre Church; Anshula Ambasta

doi:10.1016/j.mmcr.2019.07.002

Disseminated cerebral aspergillosis complicated by thrombotic microangiopathy

Med Mycol Case Rep. 2019 Jul 5:25:25-28. doi: 10.1016/j.mmcr.2019.07.002. eCollection 2019 Sep.

Authors

Robynn Lester¹, Deirdre Church^{1

2}, Anshula Ambasta^{1

3

4}

Affiliations

¹ Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
² Department of Pathology & Laboratory Medicine and Medicine, University of Calgary, Calgary, Alberta, Canada.
³ Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
⁴ Ward of the 21 Century, University of Calgary, Calgary, Alberta, Canada.

Abstract

Invasive aspergillosis (IA) is a serious condition that can affect almost any organ. Cerebral aspergillosis itself is rapidly fatal without treatment. We report a case of disseminated cerebral IA in a patient exposed to cyclophosphamide, rituximab and prednisone. This case is unique because: 1) disseminated IA has not been described in anti-glomerular basement membrane glomerulonephritis; 2) IA led to thrombotic microangiopathy with normal ADAMTS13 and 3) voriconazole toxicity necessitated use of isavuconazole for IA treatment.

Keywords: Cerebral aspergillosis; Invasive aspergillosis; Isavuconazole; Thrombotic microangiopathy; Voriconazole-induced periostitis.

Publication types

Case Reports