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Aspergillus-induced small bowel obstruction in a leukemic newborn
J H Raaf1, P K Donahoe, J T Truman
1Division of Pediatric Surgery, Children's Service, and Department of Pathology, Massachusetts General Hospital, Boston, Mass 02114, USA.
Abstract:
An infant with congenital acute myelocytic leukemia, who was being treated with chemotherapeutic agents, developed obstruction and infarction of the ileum due to occlusion of mesenteric arteries by Aspergillus hyphae. This case demonstrates how blood vessel occlusion by occult aspergillosis can present clinically as a surgical emergency.
Insights
Occult aspergillosis, a fungal infection, can cause dangerous mesenteric artery blockages. This rare complication presented as a surgical emergency in an infant with acute myelocytic leukemia.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Vascular Surgery
Background:
- Congenital acute myelocytic leukemia (AML) requires intensive chemotherapy.
- Opportunistic fungal infections are a risk in immunocompromised patients.
- Aspergillus species can cause invasive disease in susceptible individuals.
Observation:
- An infant diagnosed with congenital AML developed ileal obstruction and infarction.
- The condition was attributed to occlusion of mesenteric arteries.
- Microscopic examination revealed Aspergillus hyphae as the cause of vascular occlusion.
Findings:
- This case highlights a rare presentation of invasive aspergillosis.
- Vascular occlusion by Aspergillus hyphae led to intestinal ischemia.
- The clinical presentation mimicked a surgical emergency.
Implications:
- Occult aspergillosis should be considered in immunocompromised patients with acute abdominal symptoms.
- Early diagnosis and treatment are crucial to prevent life-threatening complications.
- This case underscores the importance of multidisciplinary care in managing complex pediatric cases.