Invasive Aspergillosis of the Stomach and Co-infection With Candida krusei in a Patient With Terminal Liver Failure: A Case Report.

Abstract	Invasive aspergillosis (IA) is diagnosed almost exclusively in immunocompromised patients. It is located mainly in the lungs or paranasal sinuses, but occasionally other organs and the gastrointestinal tract may also be affected either alone or as a part of a disseminated disease. The main risk factors predisposing to IA are neutropenia, immunosuppressive and steroid therapy, as well as severe underlying disease. Despite progress in diagnostics and therapy of IA, it is still characterized by a high mortality rate. In the disseminated aspergillosis of the gastrointestinal tract, mainly the small or large intestine are affected, rarely the upper gastrointestinal tract. To our best knowledge only a very few cases of IA of the gastric wall have been reported so far in the literature. We describe a unique case of this very rare location of IA in the stomach in a patient who underwent orthotopic liver transplantation in the course of active IA and Candida krusei infection of the stomach wall. The patient's condition improved on combination therapy of voriconazole and caspofungin.
Authors	B Sulik-Tyszka, W Figiel, M Krawczyk, M Wróblewska
Journal	Transplantation proceedings (Transplant Proc) Vol. 48 Issue 9 Pg. 3149-3152 (Nov 2016) ISSN: 1873-2623 [Electronic] United States
PMID	27932169 (Publication Type: Case Reports, Journal Article)
Copyright	Copyright Â© 2016 Elsevier Inc. All rights reserved.
Chemical References	Antifungal Agents Echinocandins Lipopeptides Caspofungin Voriconazole
Topics	Antifungal Agents (therapeutic use) Aspergillosis (complications, diagnosis, pathology) Candidiasis (complications) Caspofungin Coinfection (complications, drug therapy, microbiology) Echinocandins (therapeutic use) End Stage Liver Disease (drug therapy, surgery) Gastric Mucosa (microbiology) Humans Lipopeptides (therapeutic use) Liver Transplantation Stomach Diseases (complications, microbiology) Voriconazole (therapeutic use)

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