Revista da Sociedade Brasileira de Medicina Tropical (Jul 2014)

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

  • Luna Azulay-Abulafia,
  • Maria Auxiliadora Jeunon Sousa,
  • Andrea Pussanti,
  • Daniel Dal'Asta Coimbra,
  • Hernando Vega,
  • Fred Bernardes Filho

DOI
https://doi.org/10.1590/0037-8682-0086-2014
Journal volume & issue
Vol. 47, no. 4
pp. 533 – 536

Abstract

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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.

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