Primary Invasive Aspergillosis of the Digestive Tract: Report of Two Cases and Review of the Literature |
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| Authors: | P. Eggimann J.-C. Chevrolet M. Starobinski P. Majno M. Totsch B. Chapuis D. Pittet |
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| Affiliation: | (1) Dept. of Intensive Care Medicine and Burn Center, Centre Hospitalier Universitaire Vaudois, Bugnon 46, CH -1011 Lausanne, Switzerland;(2) Division of Medical Intensive Care, Dept. of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland;(3) Infection Control Program, Dept. of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland;(4) Division of Oncology and Hematology, Dept. of Internal Medicine, University of Geneva Hospitals, Geneva, Switzerland;(5) Division of Digestive and General Surgery, Dept. of Surgery, University of Geneva Hospitals, Geneva, Switzerland;(6) Division of Clinical Pathology, Dept. of Pathology, University of Geneva Hospitals, Geneva, Switzerland |
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| Abstract: | ![]()
Abstract Background: Disseminated aspergillosis is thought to occur as a result of vascular invasion from the lungs with subsequent bloodstream dissemination, and portals of entry other than sinuses and/or the respiratory tract remain speculative. Methods: We report two cases of primary aspergillosis in the digestive tract and present a detailed review of eight of the 23 previously-published cases for which detailed data are available. Results and Conclusion: These ten cases presented with symptoms suggestive of typhlitis, with further peritonitis requiring laparotomy and small bowel segmental resection. All cases were characterized by the absence of pulmonary disease at the time of histologically-confirmed gastrointestinal involvement with vascular invasion by branched Aspergillus hyphae. These cases suggest that the digestive tract may represent a portal of entry for Aspergillus species in immunocompromised patients. |
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