Invasive Pulmonary Aspergillosis in a Patient with Acute Lymphoblastic Leukemia

• Main Authors: Orhan Ayyıldız, Abdurrahman Işıkdoğan, Murat Çelik, Abdullah Altıntaş, Salih Hoşoğlu
• Format: Article
• Language: English
• Published: Dicle University Medical School 2004-01-01
• Series: Dicle Medical Journal
• Subjects: Amphotericin-B; Invasive Pulmonary Aspergillosis; Acute Lymphoblastic Leukemia
• Online Access: http://4181.indexcopernicus.com/fulltxt.php?ICID=887949

Fungal infections are common and life-threatening among immunosupressive patients.Invasive pulmonar aspergilloz (IPA) generally occurs when Aspergillus inhaled, but rarelywith the hematogen spread of dermal or gastrointestinal Aspergillus. We present here, IPA ina 58 year-old male patient with acute lymphoblastic leukemia (ALL). He was admitted to ourclinic with fatigue, weakness, pansitopenia, and with petechia. Supportive treatment,vincristine and prednisone was initiated. Chest roentgenogram was normal. Dyspnea andfever (39.5’C) were seen after 1 month of therapy. Thorax high resolution computerizedtomography was obtained and cavitary lesion was seen in the left upper-anterior segment oflung. Sputum and blood culture were negative. In spite of the empiric use of Meropenem 3gr/d, Vancomycin 2 gr/d and fluconazole 200 mg/d, fever was not turned to normal andclinical symptoms were not healed. On the fifth days of therapy amphotericin-B was initiatedand the other antibiotics were stopped after 3 days. General symptoms were healed on the 8thdays. Radiologic findings were improved partially after 20 days. The patient clinically is welland remains in remission and radiologic findings were turn to near normal after 10 monthsof treatment. We aimed to emphasis about treatment of empirical Amphotericin-B incritically ill patient with ALL.