Acute isolated Aspergillus appendicitis in pediatric leukemia

Yutaro Yada, Yuhki Koga, Hiroaki Ono, Yoshitomo Motomura, Genshiro Esumi, Kenichi Kohashi, Yasunori Muraosa, Katsuhiko Kamei, Toshiharu Matsuura, Yoshinao Oda, Shouichi Ohga

研究成果: Contribution to journalArticle

抜粋

Aspergillus is a widespread fungus in the environment, usually invades through the respiratory tract. Invasive aspergillosis is a fatal disseminated infection in immunocompromised hosts. Appendicitis occurs scarcely in patients with leukemia. We report a case of Aspergillus appendicitis that underwent an urgent appendectomy. An 11-year-old boy received the diagnosis of acute myeloid leukemia, because of the bone pain and results of the bone marrow study. He obtained a complete remission after cancer chemotherapy and received peripheral blood stem cell transplantation from a histocompatible sibling. Leukemia relapsed 5 months post-transplant. Induction therapy with etoposide, cytarabine and mitoxantrone was started on Candida prophylaxis. Fifteen days after the end of chemotherapy, he presented with febrile neutropenia and abdominal pain, that did not respond to broad-spectrum antibiotics. Serum levels of C-reactive protein, β-D-glucan and procalcitonin were unremarkable. Computed tomography scan revealed a swollen appendix and the adjacent tissue inflammation. An urgent appendectomy led to a tentative diagnosis of Aspergillus appendicitis based on the histopathological findings of many fungal hyphal forms. Panfungal polymerase chain reaction using DNA extracted from the lesion determined the pathogen of Aspergillus niger. There was no evidence of invasive aspergillosis. During the prolonged anti-fungal therapy, he achieved a remission of leukemia and underwent the second hematopoietic cell transplantation. To our knowledge, Aspergillus appendicitis was reported to occur in 5 leukemia patients. Four of them survived after appendectomy and one died from intestinal perforation. Early surgical intervention is mandatory for a cure of Aspergillus appendicitis in neutropenic patients on Candida prophylaxis.

元の言語英語
ページ(範囲)1229-1231
ページ数3
ジャーナルJournal of Infection and Chemotherapy
26
発行部数11
DOI
出版物ステータス出版済み - 11 2020

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

フィンガープリント Acute isolated Aspergillus appendicitis in pediatric leukemia' の研究トピックを掘り下げます。これらはともに一意のフィンガープリントを構成します。

  • これを引用