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Orofacial aspergillosis in acute leukemia.

S Dreizen, G P Bodey, K B McCredie

    Oral Surgery, Oral Medicine, and Oral Pathology
    |May 1, 1985
    PubMed
    Summary

    Orofacial aspergillosis in acute leukemia patients receiving chemotherapy is challenging to treat. Antifungal therapy is ineffective without leukemia remission and restored immune defenses.

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    Area of Science:

    • Medical Mycology
    • Hematology
    • Oncology

    Background:

    • Orofacial aspergillosis is a serious opportunistic infection.
    • Patients undergoing chemotherapy for acute leukemia are particularly vulnerable.

    Purpose of the Study:

    • To describe the clinicopathologic characteristics of orofacial aspergillosis.
    • To evaluate treatment responses in this patient population.

    Main Methods:

    • Retrospective case series of thirteen hospitalized patients.
    • Analysis of clinical presentation, pathological findings, and treatment outcomes.

    Main Results:

    • Common sites included paranasal sinuses, nasal cavity, and mouth.
    • Lesions were characterized by ulceration, escharotic changes, and vascular infarction.
    • Concomitant pulmonary aspergillosis occurred in 7/13 patients.
    • Infections were unresponsive to antifungal therapy without leukemia remission.
    • Two patients achieved remission and responded to amphotericin B.

    Conclusions:

    • Orofacial aspergillosis in leukemia patients requires addressing the underlying immunosuppression.
    • Successful treatment hinges on achieving leukemia remission and immune reconstitution.
    • Amphotericin B may be effective in controlled cases post-remission.

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