Journal
MEDICAL MYCOLOGY
Volume 48, Issue 3, Pages 537-541Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/13693780903325290
Keywords
Aspergillus fumigatus; chronic granulomatous disease; osteomyelitis; interferon-gamma
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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.
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