Contributions
Abstract: PB2066
Type: Publication Only
Background
Invasive fungal infections (IFIs) cause considerable morbidity and mortality in patients with hematological neoplasia. Physicians frequently rely on a constellation of clinical signs, imaging, cultures, histopathology to establish a diagnosis and a suitable follow-up.
Aims
We presente a 20 y-o boy with AML who developed severe systemic candida tropicalis infection during induction chemotherapy neutropenia period and detected by cultures and PET CT.
Methods
This report is from the Hematology and HSCT Service of the Clinica Leon XIII - IPS Universidad de Antioquia in Medellin - Colombia. An unusually descriptive case of IFI by candida tropicalis in order to highlight some diagnostic clues and follow-up support.
Results
A 20 y-o young man presented with AML-M2, CD3,CD117,CD34CD45d,HLADR,CD15, all (+), MPOd 100%. PML-RARA (-). Current 7+3 protocol was started. Standard prophylaxis with acyclovir and fluconazole was done. At day +15 neutropenic fever appeared and some days after hemocultures yielded candida tropicalis. Concomitantly, disseminated absceded subcutaneous skin nodules were observed. In cultures from these abscess candida tropicalis grew again. PET CT revealed disseminated nodular lesions, photo. Amphotericine deoxyclate and high dose fluconazole were started. On the other hand, the patient reached leukemia complete remission. One month later his clinical condition was stable with nodular skin lesions clinically resolved, except the persistent abscess in the pericardium as shown on PET CT. Successful surgical drain of the persistent pericardial abscess was done. HiDAC consolidations were followed without candida reactivation.
Conclusion
IFIs are common during treatment of hematological malignancies. Diagnostic methods some times are inconclusive to evaluate their clinical extension and for monitoring evolution. We present here a young man with chemotherapy induced neutropenia who developed disseminated candida tropicalis infection with unusual definite extension and the monitoring of response by serial PET CT.
Session topic: 31. Infectious diseases, supportive care
Keyword(s): AML, Fungal infection, neutropenia, PET
Abstract: PB2066
Type: Publication Only
Background
Invasive fungal infections (IFIs) cause considerable morbidity and mortality in patients with hematological neoplasia. Physicians frequently rely on a constellation of clinical signs, imaging, cultures, histopathology to establish a diagnosis and a suitable follow-up.
Aims
We presente a 20 y-o boy with AML who developed severe systemic candida tropicalis infection during induction chemotherapy neutropenia period and detected by cultures and PET CT.
Methods
This report is from the Hematology and HSCT Service of the Clinica Leon XIII - IPS Universidad de Antioquia in Medellin - Colombia. An unusually descriptive case of IFI by candida tropicalis in order to highlight some diagnostic clues and follow-up support.
Results
A 20 y-o young man presented with AML-M2, CD3,CD117,CD34CD45d,HLADR,CD15, all (+), MPOd 100%. PML-RARA (-). Current 7+3 protocol was started. Standard prophylaxis with acyclovir and fluconazole was done. At day +15 neutropenic fever appeared and some days after hemocultures yielded candida tropicalis. Concomitantly, disseminated absceded subcutaneous skin nodules were observed. In cultures from these abscess candida tropicalis grew again. PET CT revealed disseminated nodular lesions, photo. Amphotericine deoxyclate and high dose fluconazole were started. On the other hand, the patient reached leukemia complete remission. One month later his clinical condition was stable with nodular skin lesions clinically resolved, except the persistent abscess in the pericardium as shown on PET CT. Successful surgical drain of the persistent pericardial abscess was done. HiDAC consolidations were followed without candida reactivation.
Conclusion
IFIs are common during treatment of hematological malignancies. Diagnostic methods some times are inconclusive to evaluate their clinical extension and for monitoring evolution. We present here a young man with chemotherapy induced neutropenia who developed disseminated candida tropicalis infection with unusual definite extension and the monitoring of response by serial PET CT.
Session topic: 31. Infectious diseases, supportive care
Keyword(s): AML, Fungal infection, neutropenia, PET