Diagnosis and Treatment of Invasive Aspergillus fumigatus Wound Infection Following Subtotal Colectomy for Perforated Toxic Megacolon in an Immunosuppressed Patient.

Document Type

Article

Publication Date

10-1-2018

Keywords

Adult; Antifungal Agents/therapeutic use; Aspergillosis/drug therapy; Aspergillosis/microbiology; Aspergillus fumigatus/isolation & purification; Colectomy; Debridement/methods; Female; Humans; Immunocompromised Host; Megacolon, Toxic/drug therapy; Megacolon, Toxic/surgery; Postoperative Complications/drug therapy; Postoperative Complications/microbiology; Surgical Wound Infection/drug therapy; Surgical Wound Infection/microbiology; Treatment Outcome; Triazoles/therapeutic use; Voriconazole/therapeutic use

Abstract

INTRODUCTION: Aspergillus is a rare cause of surgical site infection most often seen in immunocompromised patients undergoing cardiac, transplant, ophthalmologic, or burn operations; an unusual case following a colon resection is presented here.

CASE REPORT: The authors report a case of an invasive Aspergillus fumigatus infection following a subtotal colectomy for toxic megacolon. The patient was on antibiotics following the operation and chronic immunosuppression with steroids and infliximab. This was an unusual cause of a postoperative wound infection.

CONCLUSIONS: This case highlights the importance of early and accurate identification, debridement, and systemic antifungals to prevent widespread infection. With changes in antifungal care over recent years, engaging infectious disease physicians during treatment is recommended.

Clinical Institute

Digestive Health

Department

Surgery

Department

Quality

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