Related Experiment Video
Updated: May 12, 2026
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Cerebral aspergillus infection in pediatric acute lymphoblastic leukemia induction therapy
Gaurav Prakash1, Sanjay Thulkar, Sudheer Kumar Arava
1Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
Angioinvasive pulmonary infection from filamentous fungi is not an uncommon occurrence in immunocompromised patients like acute lymphoblastic leukemia (ALL). Rarely, these lesions can spread via the hematogenous route and involve multiple visceral organs. We report a case of a 14-year-old boy with ALL who developed angioinvasive pulmonary aspergillosis early in the course of induction therapy, which was followed by hematogenous dissemination and formation of multiple brain abscesses. The patient was treated with intravenous amphotericin B. There was no response to the therapy and the patient succumbed to disseminated infection. Postmortem lung biopsy confirmed angioinvasive pulmonary aspergillosis. Poor penetration of amphotericin B across the blood-brain barrier could be one of the contributory factors for poor response to antifungal therapy. We discuss the various antifungal agents with respect to their penetration in brain.
Insights
Angioinvasive pulmonary aspergillosis, a fungal infection, can spread to the brain in acute lymphoblastic leukemia (ALL) patients. Poor blood-brain barrier penetration of amphotericin B may limit treatment effectiveness for disseminated fungal infections.
Area of Science:
- Mycology
- Hematology
- Infectious Diseases
Background:
- Filamentous fungi can cause angioinvasive pulmonary infections, particularly in immunocompromised individuals such as those with acute lymphoblastic leukemia (ALL).
- Hematogenous spread of these fungal infections to multiple visceral organs is a rare but serious complication.
Observation:
- A case is presented of a 14-year-old boy with ALL who developed angioinvasive pulmonary aspergillosis during induction therapy.
- The infection subsequently disseminated hematogenously, leading to the formation of multiple brain abscesses.
Findings:
- Despite treatment with intravenous amphotericin B, the patient showed no response and succumbed to the disseminated infection.
- Postmortem lung biopsy confirmed angioinvasive pulmonary aspergillosis.
Implications:
- Poor penetration of amphotericin B across the blood-brain barrier is a potential factor contributing to treatment failure in disseminated central nervous system fungal infections.
- Further discussion is warranted regarding antifungal agents and their efficacy in penetrating the brain for treating such severe cases.
