Journal name: World Journal of Pharmaceutical Research
Original article title: Primary cutaneous aspergillosis in acute myeloid leukemia patient
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
This page presents a generated summary with additional references; See source (below) for actual content.
Subtitle: a case report
Original source:
This page is merely a summary which is automatically generated hence you should visit the source to read the original article which includes the author, publication date, notes and references.
Ahmed Mjali, Haider J. Kehiosh, Mohammed Jawad Al-Ansari, Rasha K. Muhsin, Haider Hasan Jaleel Al-Shammari
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Primary cutaneous aspergillosis in acute myeloid leukemia patient
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr201715-10178
Download the PDF file of the original publication
Summary of article contents:
Introduction
Primary cutaneous aspergillosis, although rare, has become increasingly significant in the context of immunocompromised patients, such as those undergoing intensive chemotherapy. The World Journal of Pharmaceutical Research published a case report detailing a 60-year-old male patient with acute myeloid leukemia who developed this infection following chemotherapy. Diagnosis was confirmed through microbiological culture and histological examination of necrotic tissue from a skin lesion. Successful treatment was achieved with a short course of amphotericin B.
Importance of Early Recognition
One critical concept emphasized in the case report is the importance of early recognition and diagnosis of primary cutaneous aspergillosis. The patient's lesion began as a small furuncle on the neck, which quickly escalated to a painful erythematous plaque with necrosis. Early identification of such lesions is essential, as it facilitates prompt treatment that can significantly reduce the risk of systemic dissemination of the infection. Proper evaluation and timely microbiological examinations are necessary to avoid misdiagnosis and delayed interventions.
Treatment Approach
The treatment strategy employed in this case highlights the use of antifungal therapy in managing primary cutaneous aspergillosis. Initially, amphotericin B was administered intravenously at a dosage of 1 mg/kg/day, leading to full healing of the lesion within two weeks. Following this, the patient was transitioned to an oral regimen of voriconazole for an extended period to maintain fungal suppression. This approach underscores the role of systemic antifungal agents in treating such opportunistic infections effectively, particularly in immunocompromised individuals.
Clinical Manifestations and Pathology
Another important aspect discussed is the range of clinical manifestations associated with cutaneous aspergillosis in patients with altered immune defenses. The presentation can vary widely, with lesions appearing as erythematous macules, plaques, or even hemorrhagic bullae, often progressing to necrotic ulcers. The case report illustrates the progression of the patient's lesion from a harmless furuncle to a significantly more severe condition, highlighting the unpredictable nature of fungal infections in vulnerable populations.
Conclusion
The case study serves as a reminder that primary cutaneous aspergillosis is a rare but critical condition that warrants attention in immunosuppressed patients. With the increasing population of patients at risk, especially those undergoing chemotherapy, awareness of this infection is essential for timely treatment and management. Early recognition and appropriate antifungal therapy are paramount to improve outcomes and prevent systemic spreading of the infection, ultimately demonstrating the need for heightened vigilance in clinical practice.
FAQ section (important questions/answers):
What is primary cutaneous aspergillosis?
Primary cutaneous aspergillosis is a rare fungal infection occurring in immunocompromised patients, typically following skin injuries or invasive procedures. It presents as lesions on the skin and is less common than pulmonary aspergillosis.
How was the case of cutaneous aspergillosis diagnosed?
Diagnosis was made through microbiological culture and histological examination of necrotic tissue from the lesion. The presence of septate hyphae branching at around 45 degrees suggested aspergillus species.
What treatment was provided for the patient?
The patient was treated with amphotericin B administered intravenously, starting at 1 mg/kg/day. After 14 days of treatment, the lesion completely healed with reepithelization.
What are common symptoms of primary cutaneous aspergillosis?
Symptoms can include the appearance of painful skin lesions that may grow rapidly. Initial manifestations can resemble erythematous indurated macules, papules, plaques, or necrotic ulcers covered by black eschar.
What fungi are primarily responsible for cutaneous aspergillosis?
The most common causative organisms are Aspergillus flavus, terreus, niger, and ustus. These species can be found in the environment and may cause opportunistic infections in immunocompromised individuals.
What was the outcome for the patient in this case?
After treatment, the patient's cutaneous aspergillosis lesion healed completely. However, seven months later, he died due to disease recurrence and concomitant infection.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Primary cutaneous aspergillosis in acute myeloid leukemia patient”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Chemotherapy:
Chemotherapy refers to the use of drugs to treat diseases like cancer. In this case report, it was used as induction therapy for acute myeloid leukemia (AML). Chemotherapy can immunosuppress patients, making them more susceptible to infections such as primary cutaneous aspergillosis, which highlights the importance of monitoring for infections during treatment.
2) Disease:
In the context of the case report, 'disease' refers to acute myeloid leukemia (AML) and cutaneous aspergillosis. AML is a type of cancer affecting the blood and bone marrow, while cutaneous aspergillosis is a rare fungal infection occurring primarily in immunocompromised patients, such as those undergoing chemotherapy. Understanding these diseases is crucial for appropriate treatment.
3) Species:
The term 'species' refers to different classifications of fungi, specifically aspergillus species in this case. Aspergillus flavus is the causative agent of the infection observed in the patient. Various species of aspergillus can cause opportunistic infections, particularly in immunocompromised hosts, and identifying the species is essential for effective treatment.
4) Post:
In this context, 'post' signifies the time after a significant event—in this case, post-chemotherapy. The patient developed cutaneous aspergillosis seven days after receiving chemotherapy. Monitoring patients post-chemotherapy is critical, as they are at increased risk for infections. Frequent evaluations can lead to timely diagnosis and intervention.
5) Burning (Burn, Burned, Burnt):
Burn injuries are mentioned as potential sites for primary cutaneous aspergillosis infection. Fungi like aspergillus may enter through compromised skin barriers, such as burns. Understanding this association helps in identifying at-risk patients and implementing preventive measures and treatments to mitigate the risk of developing fungal infections.
6) Discussion:
The 'discussion' section provides an opportunity to analyze and interpret the findings of the case report. It highlights the rarity of primary cutaneous aspergillosis in immunocompromised patients, explores clinical manifestations, and examines treatment options. This critical analysis is vital for enhancing understanding and improving patient management strategies.
7) Medicine:
In this report, 'medicine' refers to the field encompassing various treatments and therapies for diseases, particularly the approach to managing the patient's conditions—acute myeloid leukemia and cutaneous aspergillosis. Understanding medicine's role is crucial in ensuring appropriate interventions and improving patient outcomes.
8) Swelling:
The term 'swelling' describes the clinical manifestation observed on the patient’s neck, where a round, warm black swelling appeared post-chemotherapy. This symptom is significant as it signifies potential infection. Recognizing swelling as a possible indication of complications can prompt further investigations, leading to timely diagnoses and treatments.
9) Dressing:
The term 'dressing' refers to protective coverings applied to wounds, which can be a risk factor for cutaneous aspergillosis. Dressing-related complications can predispose immunocompromised patients to infections if the dressing creates a favorable environment for fungal growth. Proper wound care and dressing management are essential to prevent such infections.
10) Rasa (Rasha):
Rasha K. Muhsin is one of the authors associated with the case report as part of the dermatology department. Understanding the role of each contributor is important as it highlights interdisciplinary collaboration in managing complex cases. Their combined expertise ensures a comprehensive approach to patient diagnosis and treatment.
11) Ulcer:
The term 'ulcer' relates to the skin lesions that can develop in cutaneous aspergillosis. Ulcers are characterized by necrotic tissue and can signify a severe form of infection. Recognizing different presentations of skin lesions, including ulcers, is critical for prompt identification and effective management of fungal infections.
12) Blood:
The term 'blood' refers to the vital fluid in the body responsible for transporting nutrients and oxygen. In the case report, microbiological examinations of blood cultures were conducted. This emphasizes the importance of monitoring immune-compromised patients through blood tests to detect systemic infections early in their course.
13) Drug:
In this context, 'drug' specifically refers to antifungal treatments used to manage infections like cutaneous aspergillosis. Amphotericin B was administered to the patient for treatment. Understanding the role of specific drugs in combating fungal infections is essential for clinicians to make informed therapeutic decisions for affected patients.
14) Soil:
Soil is mentioned as a common source of aspergillus species, highlighting the environmental presence of these fungi. Awareness of the environmental origins of pathogens is essential, particularly for immunocompromised patients, since exposure can lead to infections. This emphasizes the need for caution and hygiene in potentially hazardous settings.
15) Male:
The term 'male' indicates the gender of the patient in this case report. Gender can influence the presentation, progression, and outcomes of certain diseases. Understanding demographic factors such as gender is vital in clinical research and treatment design, ensuring that care is tailored and effective for different patient populations.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Primary cutaneous aspergillosis in acute myeloid leukemia patient’. Further sources in the context of Science might help you critically compare this page with similair documents:
Necrotic tissue, Histological examination, Primary therapy, Systemic therapy, Amphotericin B.