Aspergiloza invazivă la un pacient cu leucemie acută limfoblastică | [Invasive aspergillosis in a child with acute lymphoblastic leukemia Voda Daniela, Spirea Dana, Oțelea Carmen]

Abstract

Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised children. We present a case of a nine-year-old boy admitted to Children Hospital Brasov with acute lymphoblastic leukemia with B cells, which developed one month after beginning chemotherapy, severe neutropenia and cough, hemoptysis, dyspnoea, chest pain, back pain, and pyuria. The imagistic evaluation revealed a pulmonary abscess, kidney abscess, and spondylodiscitis L1-L2 with paravertebral abscess. The serologic test showed high titters of aspergillus antibody. The case was interpreted as pulmonary invasive aspergillosis with renal and vertebral dissemination. This boy was treated for a period of seven months with complex antifungal therapy (intravenous and oral) in association with multiple schemes of antibiotherapy. The evolution was difficult, but favorable, with stopped chemotherapy and remission of systemic fungal infection. Chemotherapy was reintroduced after 5 months with complete remission of the underlying disease.