Sinopulmonary aspergillosis in children with hematological malignancy
No Thumbnail Available
Date
2006
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Invasive pulmonary aspergillosis is a serious infectious complication in immunocompromised especially neutropenic patients. Despite improvements in early diagnosis and effective treatment, invasive pulmonary aspergillosis is still a devastating opportunistic infection. These infections also interfere with the anticancer treatment. We report our experience in the diagnosis and therapeutic management of sinopulmonary aspergillosis in 4 children with hematologic malignancy. All patients except the first were neutropenic when sinopulmonary aspergillosis was diagnosed. Clinical signs included fever, cough, respiratory distress, swallowing difficulty, headache, facial pain-edema and hard palate necrosis. Radiodiagnostic methods showed bilateral multiple nodular infiltrations, soft tissue densities filling all the paranasal sinuses, and bronchiectasis. Diagnosis of aspergillosis was established by bronchoalveolar lavage in one case, tissue biopsy, positive sputum and positive cytology, respectively, in the other 3 cases. One patient was treated with liposomal amphotericin B and other 3 cases were treated with liposomal amphotericin B + itraconozole. Outcome was favorable in all cases except the one who died due to respiratory failure. Early diagnosis, appropriate treatment and primary disease status are important factors on prognosis of Aspergillus infections in children with hematological malignancy.
Description
Keywords
Acute Disease , Adolescent , Amphotericin B , Antifungal Agents , Aspergillosis , Burkitt Lymphoma , Child , Drug Therapy, Combination , Female , Humans , Immunocompromised Host , Itraconazole , Leukemia, Lymphocytic, Acute , Leukemia, Myeloid , Lung Diseases, Fungal , Male , Prognosis , Radiography, Thoracic , Time Factors , Tomography, X-Ray Computed , amphotericin B lipid complex , antibiotic agent , cytarabine , itraconazole , mitoxantrone , acute granulocytic leukemia , acute lymphocytic leukemia , adolescent , anamnesis , article , Aspergillus flavus , bronchiectasis , case report , child , clinical feature , febrile neutropenia , female , hematologic malignancy , human , human tissue , laboratory test , lobectomy , lung aspergillosis , lung biopsy , lung lavage , male , nasal biopsy , paranasal sinus disease , physical examination , prognosis , radiodiagnosis , respiratory failure , soft tissue disease , sputum cytodiagnosis , treatment outcome