scholarly journals Disseminated pulmonary mucormycosis involving jejunum in an acute lymphoblastic leukemia patient

2020 ◽  
Author(s):  
Lan-lan Wang ◽  
Liang Zou ◽  
Zhong-ju Chen ◽  
Yang Yi ◽  
Qin-bin Meng ◽  
...  
Keyword(s):  
Antifungal Agents ◽  
Lymphoblastic Leukemia ◽  
Unique Case ◽  
Early Administration ◽  
Pulmonary Mucormycosis ◽  
Leukemia Patient ◽  
Cunninghamella Bertholletiae ◽  
Therapeutic Outcomes ◽  
Lethal Infection ◽  
Disseminated Mucormycosis

Abstract Pulmonary mucormycosis and aspergillosis with disseminated mucormycosis involving gastrointestinalin is a very rare but lethal infection leading to an extremely mortality. Herein, we present a unique case of pulmonary co-infection with Cunninghamella bertholletiae and Aspergillus flavus, with dissmiated mycomycosis involving jejunum caused by Cunninghamella bertholletiae in a B-ALL patient with familial diabetes. Early administration of active antifungal agents at optimal doses, complete resection of all infected tissues led to improved therapeutic outcomes.

scholarly journals Disseminated Pulmonary Mucormycosis Involving the Jejunum in an Acute Lymphoblastic Leukemia Patient

2020 ◽  
Author(s):  
Lan-lan Wang ◽  
Liang Zou ◽  
Zhong-ju Chen ◽  
Yang Yi ◽  
Qin-bin Meng ◽  
...  
Keyword(s):  
Antifungal Agents ◽  
Clinical Symptoms ◽  
Lymphoblastic Leukemia ◽  
Good Condition ◽  
Lymphocytic Leukemia ◽  
Calcofluor White ◽  
Pulmonary Mucormycosis ◽  
Therapeutic Outcomes ◽  
Intravenous Amphotericin ◽  
Disseminated Mucormycosis

Abstract Background: Pulmonary mucormycosis and aspergillosis with disseminated mucormycosis involving gastrointestinalin is a very rare but lethal infection leading to extreme mortality. Case presentation: A 51-year-old female was admitted in the hematology clinic following persistent fever. Bone marrow pathology was done on the third day and the common type of acute B-lymphocytic leukemia (B-ALL) with the IKZF1 mutation was diagnosed. IVCP program was prescribed as initial treatment. After five days, broad spectrum antibiotics and voriconazole were started due to febrile neutropenia. Forty-nine days after admission, based on characteristics of the clinical pulmonary symptoms, the feature of the computed tomography (CT) and the morphological profile of the hyphae, we switched the antifungal therapy to intravenous amphotericin B (AmB) with an initial dose of 0.5 mg/kg/d. On day sixty-two, according to the abdominal CT and clinical symptoms, intestinal perforation was diagnosed and emergency surgical management was performed. Histopathology of specimens from the jejunum and ileum showed broad septate fungal hyphae. L-AmB was added to 1.0 mg/kg/d for one week, followed by fever resolution. Considering the relief of symptoms and regression of lesions on imagery, our strategy switched to oral posaconazole 0.8 g/d. The patient was discharged in good condition for continuous therapy with antifungal agents and for follow-up at the outpatient clinic.Conclusions: Direct microscopic testing with calcofluor white is the key to rapid diagnosis of mucormycosis, and early administration of active antifungal agents at optimal doses and complete resection of all infected tissues led to improved therapeutic outcomes.

scholarly journals Esophageal Erosion as a Possible Bacterial Entry Site in an Acute Lymphoblastic Leukemia Patient with Sepsis

2003 ◽  
Vol 77 (4) ◽  
pp. 395-398 ◽  
Author(s):  
Satoshi Ikegaya ◽  
Hironobu Naiki ◽  
Akira Yoshida ◽  
Takanori Ueda ◽  
Hiromichi Iwasaki
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Entry Site ◽  
Leukemia Patient ◽  
Esophageal Erosion

Xanthine lithiasis, nephrocalcinosis, and renal failure in a leukemia patient treated with allopurinol.

1987 ◽  
Vol 33 (12) ◽  
pp. 2314-2316 ◽  
Author(s):  
J L Potter ◽  
A A Silvidi
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Tumor Cell ◽  
Lymphoblastic Leukemia ◽  
Obstructive Uropathy ◽  
X Ray Diffraction ◽  
X Ray ◽  
Leukemia Patient ◽  
Similar Episode ◽  
Tumor Cell Lysis

Abstract An 11-year-old boy who presented in acute renal failure with significant increases of uric acid and phosphorus in his serum was discovered to have acute lymphoblastic leukemia. Five years later, he had a second and similar episode of acute renal failure, which was responsive to hemodialysis. After three months of daily therapy with allopurinol, a third and final episode of renal failure was unresponsive to peritoneal dialysis. Autopsy revealed an obstructive uropathy; focal nephrocalcinosis; and multiple, small, tan calculi in the calyces of both kidneys. Systemic cryptococcosis was also discovered. The stones, characterized by paper chromatography, electrophoresis, x-ray diffraction, and infrared spectroscopy, were 82% xanthine, 15% oxypurinol, and 3% hypoxanthine. We suggest that attention to the effects of accelerated tumor-cell lysis may protect renal function in patients with a large and drug-sensitive tumor cell load. Similarly, early detection of the fungal complications of leukemic therapy is an essential component of the treatment program.

scholarly journals Severe Neuropathic Pain With Concomitant Administration of Vincristine and Posaconazole

2018 ◽  
Vol 23 (5) ◽  
pp. 417-420 ◽  
Author(s):  
Mark John-Yung Lin ◽  
Megan Rose Paul ◽  
Dennis John Kuo
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Antifungal Agents ◽  
Chemotherapeutic Agent ◽  
Lymphoblastic Leukemia ◽  
Concomitant Administration ◽  
Potential Toxicity ◽  
Negative Interaction ◽  
Cell Acute Lymphoblastic Leukemia ◽  
Immunocompromised State

Vincristine is a chemotherapeutic agent with a potential toxicity of sensorimotor peripheral neuropathy. Patients receiving chemotherapy are in an immunocompromised state and may require antifungal agents. Triazole antifungals are known inhibitors of cytochrome P450 (CYP) enzymes. Vincristine is a known CYP3A4 and CYP3A5 substrate, and concomitant administration with fluconazole or voriconazole has been reported to increase vincristine toxicity and peripheral neuropathy, but there is limited literature on posaconazole in this regard. This 5-year-old girl with pre–B-cell acute lymphoblastic leukemia received vincristine while receiving posaconazole for a mucormycosis infection and developed unexpectedly severe peripheral neuropathy. After recovery, the child continued on mucormycosis prophylaxis with posaconazole with instructions to hold for 2 days before and on the day of vincristine administration. This case illustrates the potentiating effect that posaconazole had on vincristine-associated neurotoxicity, and our approach to mitigating that negative interaction.

scholarly journals Photo Quiz: An Immunosuppressed Acute Lymphoblastic Leukemia Patient with Fever and Lung Nodules

2018 ◽  
Vol 56 (9) ◽  
Author(s):  
Luca T. Giurgea ◽  
Jessica L. Dillon ◽  
Laura J. Tafe ◽  
Richard A. Zuckerman
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Lung Nodules ◽  
Leukemia Patient
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