1/113. Fatal disseminated trichoderma longibrachiatum infection in an adult bone marrow transplant patient: species identification and review of the literature.trichoderma longibrachiatum was recovered from stool surveillance cultures and a perirectal ulcer biopsy specimen from a 29-year-old male who had received an allogeneic bone marrow transplant for acute lymphoblastic leukemia. The amphotericin b (2.0 microgram/ml) and itraconazole (1.0 microgram/ml) MICs for the organism were elevated. Therapy with these agents was unsuccessful, and the patient died on day 58 posttransplantation. At autopsy, histologic sections from the lungs, liver, brain, and intestinal wall showed infiltration by branching septate hyphae. Cultures were positive for trichoderma longibrachiatum. While trichoderma species have been recognized to be pathogenic in profoundly immunosuppressed hosts with increasing frequency, this is the first report of probable acquisition through the gastrointestinal tract. Salient features regarding the identification of molds in the trichoderma longibrachiatum species aggregate are presented.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
2/113. Disseminated fusarium infection identified by the immunohistochemical staining in a patient with a refractory leukemia.The difficulty and uncertainty encountered in diagnosing a systemic mycosis often lead to a delay in starting antifungal therapy. We reported a disseminated infection of multiple fungal isolates including fusarium species during donor leukocyte transfusion (DLT) after allogeneic bone marrow transplantation in a 20-year-old woman with a refractory leukemia. skin lesions are the feature of fusarium and occur in the early period of the infection. In this case, during immunosuppression state after DLT, she presented with the whole body ache and erythematous lesions which appeared rapidly on her trunk and extremities. While administration of amphotericin b was started, her condition was further deteriorated and she died. autopsy materials revealed that she had multiple fungal infection with different isolates, including aspergillus and candida in the brain, lung and liver, but not in the skin. With the immunohistochemical staining with specific antibody, fusarium or aspergillus infection was identified from the biopsy skin or autopsy brain, respectively. This rapid and specific immunohistochemical method may be useful for the diagnosis and treatment of invasive fungal infection without delay.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |
3/113. splenic rupture in children with hematologic malignancies.BACKGROUND: splenic rupture is an uncommon but life-threatening complication of leukemias and lymphomas, and is reported mostly in adults. The authors investigated the frequency with which splenic rupture is diagnosed in pediatric patients with hematologic malignancies and reviewed its clinical profile and outcome. methods: The data base of St. Jude Children's research Hospital was searched for cases coded as splenic laceration or rupture, splenic infarction, or splenectomy in patients diagnosed with lymphoma or leukemia between January 1962 and December 1997. The medical records of patients with histopathologic or radiologic evidence of splenic rupture were reviewed. The time spanned by the study was divided into early (1962-1990) and recent (1991-1997) eras to reflect the availability of modern diagnostic imaging techniques. RESULTS: Seven children experienced splenic rupture. They were between ages 5-17 years. There were four males and three females. Primary diagnoses included acute myeloid leukemia (four patients), acute lymphoblastic leukemia (two patients), and Hodgkin lymphoma (one patient). Five patients were diagnosed in the recent era and two in the early era. Four patients had radiologic or bacteriologic evidence of fungal infection concomitant with the splenic event. Of five deaths, only two were related causally to splenic rupture; these occurred in the early era. All seven acute episodes of splenic rupture were managed conservatively without surgery. CONCLUSIONS: The overall frequency with which splenic rupture was detected in children with hematologic malignancy at the study institution was 0.18%. In the recent era, the frequency of detection was 9-fold higher (0.55%) than that of the early era (0.06%). Improved imaging techniques and increased utilization of imaging studies may account for the increased incidental detection of "preclinical" splenic rupture. adolescent age group, acute myeloid leukemia (especially acute promyelocytic leukemia), a high leukocyte count, thrombocytopenia, and coagulopathy may predispose children with leukemia to pathologic splenic rupture. Fungal infection frequently was associated with splenic rupture and may play a role in its pathogenesis.- - - - - - - - - - ranking = 7.3754356679348keywords = leukemia, myelocytic, myeloid leukemia (Clic here for more details about this article) |
4/113. meningitis caused by rhodotorula.A case of rhodotorula meningitis in a 21 year old male compromised with acute lymphoblastic leukemia is reported. The yeast was identified as rhodotorula rubra (Demme) Lodder.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
5/113. Disseminated infection caused by scedosporium prolificans in a patient with acute multilineal leukemia.In this report, we describe a case of disseminated infection caused by scedosporium prolificans (S. inflatum) in a patient affected by chemotherapy-induced acute multilineal leukemia and neutropenia. For the fungus isolated in four blood cultures, high MICs of currently available antifungal agents were found. Postmortem examination revealed multiorgan involvement.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |
6/113. trichosporon cutaneum (trichosporon asahii) infection mimicking hand eczema in a patient with leukemia.trichosporon Cutaneum is a yeast-like fungus that causes white piedra and onychomycosis. Recently, it has also been recognized as an opportunistic pathogen in immunocompromised hosts. We describe a 64-year-old woman who developed a superficial trichosporon infection mimicking hand eczema during chemotherapy for her chronic myelocytic leukemia. To our knowledge, no cases of superficial infection like this one have previously been reported. This case suggests that careful examination is required in diagnosing trichosporon infection in immunocompromised hosts, because the infection can be invasive or unusual in appearance.- - - - - - - - - - ranking = 5.2816596411708keywords = leukemia, myelocytic (Clic here for more details about this article) |
7/113. Blastoschizomyces capitatus infection in acute leukemia patients.Blastoschizomyces capitatus (BC), a filamentous fungus of genus Trichosporum, is as an important opportunistic pathogen in the compromised host. Within the past 10 years, 47 cases of BC infection have been published. Most of the patients had acute leukemia (AL) or related disorders and had received chemotherapy treatment. Due to BC's resistance to currently used antifungal agents, this infection represents a therapeutic challenge and serious complication in the treatment of hematology malignancies. Here we report our experience with BC infection in four patients with acute leukemia or related disorders.- - - - - - - - - - ranking = 6keywords = leukemia (Clic here for more details about this article) |
8/113. The use of adjuvant interferon-gamma therapy for hepatosplenic Blastoschizomyces capitatus infection in a patient with leukemia.Hepatosplenic fungal infections are a devastating complication of neutropenia. Despite aggressive antifungal therapy, clinical response may be poor. We describe a case of hepatosplenic Blastoschizomyces capitatus infection that responded to adjuvant interferon-gamma therapy.- - - - - - - - - - ranking = 4keywords = leukemia (Clic here for more details about this article) |
9/113. Successful treatment of disseminated fusarium infection in an infant with leukemia.Disseminated fusarium infection in an immunocompromised host is intractable and results in high mortality. We provide the first full case report on successful treatment of a disseminated fusarium infection in an infant. The 6-month-old infant, whose family raised livestock, had infantile leukemia. During the neutropenic period after intensive chemotherapy, vomiting, diarrhea, fever, subcutaneous nodes, and coughing appeared. pneumonia was diagnosed, and fusarium moniliforme was isolated from blood culture. A central venous catheter was removed. granulocyte colony-stimulating factor (G-CSF) and amphotericin b (AMPH-B) (total dose, 65 mg/kg) were administered continuously for 8 weeks. The infection was resolved according to improvement of clinical and laboratory findings, and intensive chemotherapy was restarted for the leukemia. cord blood stem cell transplantation from an unrelated donor was performed. The fusarium infection did not recur, but after transplantation, leukemia relapsed. Treatment of neutrophils using G-CSF, AMPH-B, and local treatment induced resolution of the disseminated fusarium infection in this immunocompromised host with malignancy. We suggest caution for patients living in an environment conducive to the development of fusarium infection because of the particular risk of infection.- - - - - - - - - - ranking = 7keywords = leukemia (Clic here for more details about this article) |
10/113. Disseminated Neocosmospora vasinfecta infection in a patient with acute nonlymphocytic leukemia.We report Neocosmospora vasinfecta infection following chemotherapy for acute nonlymphocytic leukemia. N. vasinfecta, a plant pathogen, was identified by culture and genetic sequencing. Susceptibility testing revealed in vitro resistance for common antifungals.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |
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