A Case Report of Aspergillosis with Colonic Ulcers in Digestive System

Mitsuru Kikuchi, Shigeatsu Endo, Yukio Kuwata, Takehiko Satoh*, Katsuya Inada*, Masao Yoshida**

Critical care and Emergency Center, Iwate Medical University
*The Second Department of Pathology School of Medicine, Iwate Medical University
**Department of Bacteriology School of Medicine, Iwate Medical University

We experienced a case of digestive mycosis with Aspergillus. The patient was a 62-year-old woman who was introduced to our center for shock that developed 2 days after the appearance of abdominal pain. Ileocaecal resection was performed for strangulated ileus. On day 7, bloody flux occurred and endoscopy revealed sigmoid psudomembranous formation. On day 14, re-operation was performed for persistent digestive hemorrage, Ischemic changes observed in the descending and sigmoid colonic regions were resected, with an artificial anus being prepared. From about this time, β-glucan became positive and was as high as 310 pg/ml on day 22, leading to the diagnosis of deep seated mycosis. The contemporaneous microbiological examination revealed the involvement of aspergillus, and the pathohistological examination revealed colonic ulceration and worm bodies of Aspergillus in the ulcer base. Following the present case, β-glucan was also effective in mycosis with other than Candida like Aspergillus, and its measurement was confirmed to be effective for the diagnosis of fungemia.

Key words
disseminated aspergillosis, fungemia, 1-3-β-Dglucan

Reprint requests
Mitsuru Kikuchi Critical Care and Emergency Center, Iwate Medical University
19-1 Uchimaru, Morioka, 020 JAPAN

Accepted
May 11, 1993

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