Isolated enteric aspergillosis in a non severely immunocompromised patient. Case report and literature review

Invasive aspergillosis is a life-threatening, opportunistic fungal infection that mainly affects immunocompromised patients, particularly those receiving immunosuppressive therapy or high-dose corticosteroids. The most common portal of entry in aspergillosis is the lung, so the isolated occurrence of intestinal aspergillosis in the absence of pulmonary disease is an unusual pattern.Case reportWe report a case of a lung cancer patient who did not receive chemotherapy, presenting to the emergency department with fever and chills. The patient also developed abdominal pain and bloody diarrhoea during his hospitalisation. Colonoscopy revealed diffuse epithelial and subepithelial oedema of the terminal ileum, linear ulcers, denudation of the mucosa, and necrosis. Histopathological examination of terminal ileum diffuse biopsies showed haemorrhagic infiltrations, while microscopy revealed Y-shaped, branching septate hyphae, diagnostic for Aspergillus fungi. Additionally, the culture of biopsy samples showed the growth of Aspergillus fumigatus. The patient was negative for Aspergillus antibodies in his blood, and bronchoscopy and sputum samples were negative as well.ConclusionThis is a rare case of isolated aspergillosis of the small intestine, as there is no pulmonary or other systemic participation, as it also happens in a patient not being in a severely immunocompromised state.