Abstract
We report a case of invasive aspergillosis due to Aspergillus fumigatus involving the cervical and thoracic vertebrae and upper mediastinum of a 17 year-old Saudi male with chronic granulomatous disease (CGD). The patient did not respond to a long course of liposomal amphotericin B but did to surgical drainage and a combination of caspofungin and itraconazole with subsequent suppression with oral voriconazole. Fourteen months after the start of therapy, the patient had anterior dislocation of T2 thoracic vertebra with cord transection and quadriplegia. He was then treated intravenously with liquid itraconazole and interferon-gamma. The patient made a remarkable recovery over a 2-year period and was eventually able to walk independently. Thus, a combination of antifungals and interferon-gamma may have resulted in the positive outcome in this case.
Acknowledgments
The authors acknowledge the use of Saudi Aramco Medical Services Organization (SAMSO) facilities for the research data utilized in this manuscript. Opinions expressed in this article are those of the authors and not necessarily of SAMSO. We also like to thank the Fungus Testing Laboratory, University of Texas Health Science Center at San Antonio for their assistance in identifying the etiologic agent and the susceptibility testing of the isolates.
Funding source
None
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.