Abstract

In invasive aspergillosis (IA), which is among the opportunistic infections in immunocompromised individuals, high rates of morbidity and mortality can be observed. This disease is most commonly seen in the respiratory tract, but has also been reported in the sinuses, central nervous system, skin, liver, and urinary tract. Aspergillosis, which can be seen outside the lung, is usually seen in disseminated disease. Although aspergillosis, which can be seen in the gastrointestinal tract, is the least common form, it may progress with complications in the follow-up. We present a patient who was followed up with the diagnosis acute leukemia and developed small bowel ileus due to IA after pulmonary aspergillosis while chemotherapy was continuing. We presented our case in a literature review. Pulmonary aspergillosis due to aspergillus was detected in a 3-year-old patient, who was diagnosed with acute lymphoblastic leukemia and relapsed while chemotherapy was continuing. The patient, who was started antifungal due to pulmonary aspergillosis, developed complaints of fever and vomiting in the follow-up. Physical examination revealed distension, defense, and tenderness in the abdominal examination. In the patient who underwent laparotomy, multiple necrotic segments were detected in the terminal jejunum and proximal ileum during the operation. Pathologically, aspergillus was detected in the resected area. Voriconazole and caspofungin were added to the patient who underwent ileum resection, but the patient died. At the time of the literature search, 12 articles on intestinal aspergillus were found. Gastrointestinal manifestations of aspergillosis may not be very specific, except for abdominal pain. If the patient has a prolonged neutropenic period, acute abdomen, gastrointestinal aspergillosis should be kept in mind even if there is no pulmonary involvement. Antifungal treatment should be started in the early period and surgical intervention should be considered in the early period for patients with acute abdomen and ileus. Dual therapy in antifungal therapy, such as combination therapy with caspofungin and voriconazole, is controversial.