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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
08:01

Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology

Published on: March 22, 2012

[Fatal cerebral and pulmonary aspergillosis in acute leukemia in a child]

V Hue1, A Martinot, A Deschildre

  • 1Service de réanimation infantile, Hôpital Calmette, Lille.

Annales De Pediatrie
|October 1, 1990
PubMed

Insights

Invasive pulmonary aspergillosis in a child with acute lymphoblastic leukemia presented unusually with pneumothorax and cerebral aspergillosis, leading to a fatal outcome. Early diagnosis and prompt amphotericin B treatment are crucial for invasive aspergillosis.

Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Acute lymphoblastic leukemia (ALL) treatment can lead to immunosuppression, increasing the risk of invasive fungal infections.
  • Invasive aspergillosis is a serious opportunistic infection, particularly in immunocompromised patients.

Observation:

  • A 2.5-year-old child with ALL developed invasive pulmonary aspergillosis with pneumothorax immediately after induction therapy.
  • Neurological complications, including status epilepticus attributed to cerebral aspergillosis, occurred despite amphotericin B treatment.
  • The patient experienced a fatal outcome.

Findings:

  • Invasive pulmonary aspergillosis often presents as non-specific pneumonia, but pneumothorax is an unusual manifestation.
  • Thoracic CT scans and fiberoptic bronchoscopy are key diagnostic tools for pulmonary aspergillosis.
  • Hemoptysis and excavated lesions on radiography suggest aspergillosis upon recovery from bone marrow aplasia.
  • Cerebral aspergillosis must be considered in immunocompromised patients with neurological symptoms, fever, and pneumonia.

Implications:

  • Prompt diagnosis and treatment initiation are critical for improving outcomes in invasive aspergillosis.
  • Intravenous amphotericin B is recommended when broad-spectrum antimicrobial therapy fails to resolve fever in agranulocytic patients.
  • This case highlights the importance of considering unusual presentations and disseminated disease in pediatric invasive aspergillosis.

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