A Case of Invasive Maxillary and Orbital Aspergillosis Inhematopoietic Stem Cell Transplantation Recipient with Severe Aplastic Anemia

ABSTRACT

Invasive aspergillosis (IA) of the paranasal sinuses is a rare infectious complication associated with allogeneic hematopoietic stem cell transplantation (HSCT). However, immunocompromised patients are particularly at risk of fulminant IA. The high risk of an invasive fungal infection (IFI) following allogeneic HSCT is due to several factors, including neutropenia before engraftment, disruption of mucosal barriers by various preparative regimens and the use of broad-spectrum antimicrobial agents, as well as the immunosuppressive effects of prophylaxis and treatment of GVHD. As the therapy for an IFI following allogeneic HSCT is often unsuccessful, the mortality rate is increased by 95%. Therefore, early diagnosis is important to overcome the high mortality of this destructive disease. In previous studies, high risks for the early onset of IA were demonstrated in patients with severe aplastic anemia (SAA), independent of the day of engraftment. Here, we report a case of invasive aspergillosis of the maxillary sinuses and orbit in a 50 years old man with SAA, who underwent an allogeneic HSCT from a HLA-matched sibling conditioned with Cytoxan/Fludara/ATG.