Destruction of the Nasal Septum by Aspergillus Infection after Autologous Bone Marrow Transplantation

Abstract

The New England Journal of Medicine 1. Versaci F, Gaspardone A, Tomai F, et al. A comparison of coronaryartery stenting with angioplasty for isolated stenosis of the proximal left anterior descending coronary artery. N Engl J Med 1997;336:817-22. 2. Beatt KJ, Serruys PW, Luijten HE, et al. Restenosis after coronary angioplasty: the paradox of increased lumen diameter and restenosis. J Am Coll Cardiol 1992;19:258-66. 3. Cohen EA, Lesperance J, Sykora K, Bourassa MG, Schwartz L. A distinction between process and outcome of lumen renarrowing after coronary angioplasty. J Am Coll Cardiol 1994;73:962-4. 4. Kuntz RE, Gibson CM, Nobuyoshi M, Baim DS. Generalized model of restenosis after conventional balloon angioplasty, stenting and directional atherectomy. J Am Coll Cardiol 1993;21:15-25. The New England Journal of Medicine Downloaded from nejm.org at CAMBRIDGE UNIVERSITY LIBRARY on August 11, 2015. For personal use only. No other uses without permission.

Isolated Nasal Septum Necrosis Caused by Aspergillus flavus in an Immunocompromised Child

“…Nasal septal fungal abscesses complicating nasal trauma, surgical procedures, sinus and dental infections have been previously reported (2, 3). To our knowledge, there has been only one report of isolated nasal septal aspergillosis in an immunocompromised child without any antecedent traumatic event (1). This was a 15-year-old boy with necrosis of the nasal septum due to Aspergillus infection after bone marrow transplantation for acute myelogenous leukemia (1).…”

“…To our knowledge, there has been only one report of isolated nasal septal aspergillosis in an immunocompromised child without any antecedent traumatic event (1). This was a 15-year-old boy with necrosis of the nasal septum due to Aspergillus infection after bone marrow transplantation for acute myelogenous leukemia (1). The patient had no evidence for sinus involvement and no history of trauma.…”

“…The patient had no evidence for sinus involvement and no history of trauma. He responded to therapy with amphotericin B and granulocyte colony-stimulating factor (1). This presentation of aspergillosis is likewise rare in adults.…”

“…A summary of the adult and pediatric cases of isolated nasal septum aspergillosis identified by literature review is presented in Table 1. Predisposing risk factors for isolated nasal septum aspergillosis include prolonged neutropenia, severe immunosuppression, trauma or surgical procedures, and broad spectrum antibiotics therapy (1–4). …”

“…Nasal septal infection can also result from progression of the fungal infection from the adjacent sinuses. Extensive search of the English language literature involving pediatric patients has identified only one case of a 15-year-old boy, an autologous bone marrow transplant recipient for acute myelogenous leukemia, who developed nasal septal necrosis caused by Aspergillus flavus without any antecedent trauma or surgery (1). We report the second pediatric case of nasal septum necrosis due to Aspergillus infection in a child with acute lymphoblastic leukemia (ALL) with no previous history of trauma or surgical procedures.…”