title: Complicated pulmonary aspergillosis with pneumothorax and pneumopericardium in a child with acute lymphoblastic leukemia.
abstract: Invasive aspergillosis is a fungal infection that is being observed increasingly in immunocompromised patients due to the use of more aggressive chemotherapeutic regimens. To our knowledge, no case of pneumothorax and pneumopericardium associated with invasive pulmonary aspergillosis has been reported to date. High-dose amphotericin B (1 to 1.5 mg/kg/day) is the treatment of choice, although severe side effects, especially hypokalemia, are very common. Itraconazole is considered to be a therapeutic alternative for invasive pulmonary aspergillosis in immunocompromised patients. A rare combination of pneumothorax and pneumopericardium associated with systemic aspergillosis in a child with acute lymphoblastic leukemia is described. Treatment with low-dose amphotericin B and itraconazole achieved complete resolution of the foregoing complications.
authors.affiliation: Department of Pediatric Hematology and Oncology, Hospital Infantil Niño Jesús, Autonomous University of Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Merino
authors.forename: M A
authors.initials: MA
authors.lastname: Díaz
authors.forename: M
authors.initials: M
authors.lastname: Ramírez
authors.forename: D
authors.initials: D
authors.lastname: Ruano
authors.forename: L
authors.initials: L
authors.lastname: Madero
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage; D001228:Aspergillosis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D002648:Child; D006801:Humans; D016867:Immunocompromised Host; D017964:Itraconazole / Q000008:administration & dosage; D008172:Lung Diseases, Fungal / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D011026:Pneumopericardium / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D011030:Pneumothorax / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D012074:Remission Induction
chemical_list: D017964:Itraconazole; D000666:Amphotericin B