ASPERGILOZA INVAZIVA LA UN PACIENT CU LEUCEMIE ACUTA LIMFOBLASTICA

Abstract

Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised children. We present a case of nine year old boy admitted in Children Hospital Brasov with acute lymphoblastic leukaemia with B cells, which developed one month after beginning chemotherapy, severe neutropenia and cough, haemoptysis, dyspnoea, chest pain, back pain and pyuria. Imagistic evaluation revealed pulmonary abscess, kidney abscess, spondylodiscitis L1-L2 with paravertebral abscess. 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 a period of seven month with complex antifungal therapy (intravenous and oral) in association with multiple scheme of antibiotherapy. The evolution was difficult, but favourable, with stopped chemotherapy and remission systemic fungal infection. Chemotherapy was reintroduced after 5 months with complete remission of the underlying disease.