Rapports de cas cliniques et médicaux

AIsolated Aspergillosis of Biliary Tract in a Patient with Both Solid Organ Transplantation and Haematological Malignancy? A Case Report

Abstract

Rosario Di Maggio1, Giuseppina Calvaruso1, Disma Renda1, Veronica Di Salvo1, Antonella Vulcano2, Barbara Bartolini2, Emiliano Maresi3, Aroldo Gabriele Rizzo4 and Aurelio Maggio1

Aspergillus is a ubiquitous mould that can cause a wide variety of clinical syndromes ranging from mere colonization to fulminant invasive disease. Invasive aspergillosis (IA) is the most severe presentation of aspergillosis. The lung is usually the portal of entry, from which the pathogen may disseminate to almost any organ, often the brain and skin. The diagnosis remains a significant challenge. IA is generally encountered in immunocompromised patients with steroid treatment, chemotherapy resulting in severe neutropenia, hematopoietic stem cell, and solid organ transplantation. We reported a case of aspergillosis presented as cholangitis, with no lung involvement, in a patient with history of kidney transplantation and recent Diagnosis of Large B-Cell Lymphoma (DLBCL). The patient had several predisposing factors, such as immunosuppressive drug therapy and steroid therapy. The patient died 50 days after a diagnostic splenectomy for DLBCL. The Polymerase Chain Reaction (PCR) assessment performed on biopsy specimen from duodenum was positive for Aspergillus spp. It is a case of rare, isolated aspergillosis of biliary tract in a patient with both solid organ transplantation and haematological malignancy.