Evidence map›Paper›PMID 29357049›Full record

SynthesisInfection2018

Multiple small bowel perforations due to invasive aspergillosis in a patient with acute myeloid leukemia: case report and a systematic review of the literature.

Gregorio Di Franco, Enrico Tagliaferri, Erica Pieroni, Edoardo Benedetti, Simone Guadagni, Matteo Palmeri, Niccolò Furbetta, Daniela Campani, Giulio Di Candio, Mario Petrini and 2 more

Registry-linked trialAbstract readCase ReportsSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Infection, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04813679 (Bed-side Ultrasound in the Evaluation of Gastro-intestinal Tract and Neutropenic Enterocolitis), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04813679 completednot on this map

Bed-side Ultrasound in the Evaluation of Gastro-intestinal Tract and Neutropenic Enterocolitis (NEC) in Neutropenic Patients.

TypeobservationalSponsorAzienda Ospedaliero, Universitaria PisanaRan2007 to 2018Enrolled1,740ConditionsNeutropenic EnterocolitisArmsBed side Ultrasound Sonography
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. A Repertoire of Clinical Non-Dermatophytes Moulds.Journal of fungi (Basel, Switzerland) · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Gregorio Di FrancoGeneral Surgery Unit, Department of Surgery, Translational and new Technologies in Medicine, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy.
Enrico TagliaferriInfectious Diseases Unit, Azienda Ospedaliera Universitaria Pisa, Pisa, Italy.
Erica PieroniGeneral Surgery Unit, Department of Surgery, Translational and new Technologies in Medicine, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy.
Edoardo BenedettiHaematology Unit, University of Pisa, Pisa, Italy.
Simone GuadagniGeneral Surgery Unit, Department of Surgery, Translational and new Technologies in Medicine, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy.
Matteo PalmeriGeneral Surgery Unit, Department of Surgery, Translational and new Technologies in Medicine, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy.
Niccolò FurbettaGeneral Surgery Unit, Department of Surgery, Translational and new Technologies in Medicine, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy.
Daniela CampaniDivision of Surgical Pathology, Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.
Giulio Di CandioGeneral Surgery Unit, Department of Surgery, Translational and new Technologies in Medicine, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy.
Mario PetriniHaematology Unit, University of Pisa, Pisa, Italy.
Franco MoscaEndoCAS (Center for Computer Assisted Surgery), University of Pisa, Pisa, Italy.
Luca MorelliGeneral Surgery Unit, Department of Surgery, Translational and new Technologies in Medicine, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy. luca.morelli@unipi.it.ORCID http://orcid.org/0000-0002-7742-9556
University of Pisa · ITAzienda Ospedaliera Universitaria Pisana · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeInvasive aspergillosis (IA) represents a major cause of morbidity and mortality in immunocompromised patients. Involvement of the gastrointestinal tract by Aspergillus is mostly reported as part of a disseminated infection from a primary pulmonary site and only rarely as an isolated organ infection.

methodsWe report a case of small bowel perforation due to IA in a patient with acute leukemia under chemotherapy and pulmonary aspergillosis. We performed a systematic review of the literature as well.

resultsA 43-year-old man with acute myeloid leukemia under chemotherapy developed severe neutropenia and pulmonary aspergillosis due to Aspergillus flavus. He developed melena and hemodynamic failure and a contrast-enhanced ultrasound scan suggested active intestinal bleeding. During emergency laparotomy we found multiple intestinal abscesses, several perforations of intestinal loop and Aspergillus flavus was isolated from the abscesses. Resection of the jejunum was performed. The patient received voriconazole and finally recovered. The patient is now alive and in complete disease remission. From literature review we found 35 intestinal IA previously published in single case reports or small case series as well.

conclusionClinical manifestations of gastrointestinal aspergillosis are nonspecific, such as abdominal pain, and only occasionally it presents as an acute abdomen. Antemortem detection of bowel involvement is rarely achieved and, only in cases of complicated gastrointestinal aspergillosis, the diagnosis is achieved thanks to the findings during surgery. Gastrointestinal aspergillosis should be suspected in patients with severe and prolonged neutropenia with or without pulmonary involvement in order to consider the right therapy and prompt surgery.

Indexed as

Immunocompromised HostAdultAntifungal AgentsAspergillosisHumansIntestinal PerforationIntestine, SmallInvasive Fungal InfectionsLeukemia, Myeloid, AcuteMaleNeutropeniaTreatment OutcomeVoriconazoleAntifungal AgentsVoriconazoleAcute myeloid leukemiaDisseminated aspergillosisGastrointestinal aspergillosisSmall bowel perforation

Identifiers

PMID29357049
OpenAlexW2785081976

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.