Successful Antifungal Combination Therapy and Surgical Approach for Aspergillus fumigatus Suppurative Thyroiditis Associated with Thyrotoxicosis and Review of Published Reports

Mycopathologia. 2017 Oct;182(9-10):839-845. doi: 10.1007/s11046-017-0145-5. Epub 2017 May 29.

Abstract

In immunocompromised patients, Aspergillus infections are important causes of morbidity and mortality. We describe a patient with cryoglobulinemic vasculitis who developed disseminated invasive aspergillosis with thyrotoxicosis caused by Aspergillus fumigatus. The diagnosis was based upon radiological, microbiological and pathological findings. The patient was treated successfully with voriconazole and caspofungin treatment followed by total thyroidectomy. We provide an overview of published reports on Aspergillus thyroiditis with an emphasis on therapeutic approaches.

Keywords: Aspergillosis; Aspergillus thyroiditis; Fungal thyroiditis; Immunocompromised host; Suppurative thyroiditis; Thyrotoxicosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antifungal Agents / administration & dosage*
  • Aspergillosis / diagnosis
  • Aspergillosis / drug therapy*
  • Aspergillosis / surgery*
  • Aspergillus fumigatus / isolation & purification
  • Caspofungin
  • Cryoglobulinemia / complications
  • Cryoglobulinemia / diagnosis
  • Drug Therapy, Combination / methods*
  • Echinocandins / administration & dosage
  • Humans
  • Immunocompromised Host
  • Invasive Fungal Infections / complications
  • Invasive Fungal Infections / diagnosis
  • Invasive Fungal Infections / drug therapy
  • Invasive Fungal Infections / surgery
  • Lipopeptides / administration & dosage
  • Male
  • Thyroidectomy*
  • Thyroiditis, Suppurative / complications
  • Thyroiditis, Suppurative / diagnosis
  • Thyroiditis, Suppurative / drug therapy*
  • Thyroiditis, Suppurative / surgery*
  • Thyrotoxicosis / complications
  • Thyrotoxicosis / diagnosis
  • Thyrotoxicosis / surgery
  • Treatment Outcome
  • Voriconazole / administration & dosage

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Caspofungin
  • Voriconazole