Acute pulmonary aspergillosis in patient undergoing chemotherapy for lymphoma (Paediatric)

Case History Name: 

Case number: 

58

Summary: 

A 5-year-old Egyptian girl undergoing intensive antineoplastic chemotherapy for large T cell lymphoma, developed a necrotic lesion on the right wrist as well as pleural effusions and lung opacities on CT san, consistent with pulmonary and disseminated aspergillosis. A skin biopsy revealed numerous branching fungal hyphae consistent with aspergillosis; A. flavus grew on culture from a skin biopsy of tissue obtained from the left arm. She was treated with AmBisome (9mg/Kg) but the disease progressed and micafungin was added after 10 days. After A. flavus was grown from skin biopsy, the dose of micafungin was increased from 1.5-3.0 mg/Kg/d and given for 9 months daily. There was significant improvement in pulmonary lesion size over this time period and a needle biopsy of the lung was negative for hyphae.

Species: 

  • Aspergillus flavus