Invasive aspergillosis in a user of inhaled cocaine: rhinosinusitis with bone and cartilage destruction

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Luna Azulay-Abulafia, Maria Auxiliadora Jeunon Sousa, Andrea Pussanti, Daniel Dal'Asta Coimbra, Hernando Vega, Fred Bernardes Filho
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2014
• Subjects: Aspergillosis; Aspergillus flavus; Rhinosinusitis; Cocaine addiction; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0086-2014; https://doaj.org/article/21b21bae3cef4f38af17fcd8f7e316e8

Aspergillosis is an infection caused by saprophytic fungi of the genus Aspergillus, which typically occurs in immunosuppressed individuals, but has also been reported in immunocompetent patients. The main routes of entry are the respiratory tract, skin, cornea, and ear, and the infection may be localized or disseminated by contiguity or vascular invasion. We report a severe case of rhinosinusitis with cutaneous involvement, caused by invasive aspergillosis, in an immunocompetent user of inhaled cocaine. Invasive aspergillosis related to cocaine abuse has not yet been reported in the literature. After itraconazole treatment and surgical debridement, complete clinical remission was achieved. Nasal reconstruction with a skin graft over a silicone prosthesis resulted in a satisfactory esthetic outcome.