Korean J Hematol.  2005 Sep;40(3):205-209. 10.5045/kjh.2005.40.3.205.

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

  • 1Department of Internal Medicine, College of Medicine, Inje University, Busan, Korea. yjoo@inje.ac.kr
  • 2Department of Ophthalmology, College of Medicine, Inje University, Busan, Korea.
  • 3Department of Otorhinolaryngology, College of Medicine, Inje University, Busan, Korea.


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.


Maxillary sinus; Orbit; Aspergillosis; Severe aplastic anemia; Allogeneic hematopoietic stem cell transplantation

MeSH Terms

Anemia, Aplastic*
Anti-Infective Agents
Early Diagnosis
Hematopoietic Stem Cell Transplantation
Immunocompromised Host
Maxillary Sinus
Middle Aged
Paranasal Sinuses
Stem Cell Transplantation*
Stem Cells*
Anti-Infective Agents


  • Fig. 1. The gross appearance of the patient showed a slight left exophthalmos, protrusion of lower conjunctival mucosa, left periorbital and cheek swelling.

  • Fig. 2. Endoscopic findings of left maxillary sinus showed brownish white discoloration and edematous necrotic mucosa which were suggestive findings of fungal infection.

  • Fig. 3. Computed tomography scan showed left maxillary and frontoethmoid sinus inflammation with extension into inferior part of left orbit.

  • Fig. 4. Histologic examination of surgical specimens showed abundant neutrophilic fibrinoid exudative material containing Aspergillus hyphae which was broad, septate, and branch at about 45° (Gomori Metanamine Silver stain, original magnification ×400).

Cited by  1 articles

Invasive Aspergillosis of the Paranasal Sinuses Invading Skull Base : Successful Treatment with Voriconazole
Chai Ryoung Eun, Jung Yeon Heo, Ji Yun Noh, Young Kyung Youn, Hyun Joo Lee, Bong Kyung Shin, Jacob Lee, Joon Young Song, Hee Jin Cheong, Woo Joo Kim
Infect Chemother. 2008;40(2):110-115.    doi: 10.3947/ic.2008.40.2.110.


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