Pythium insidiosum pleuropericarditis complicating pneumonia in a child with leukemia.
We describe a 12-year-old boy with acute myeloid leukemia who developed pleuropericarditis while he was neutropenic and was receiving intravenously administered antibiotic and antifungal therapy for pneumonia. A KOH preparation of the purulent material from an extensive diagnostic and therapeutic pleuropericardial drainage procedure revealed multiple irregularly septate hyphae, and cultures yielded the organism Pythium insidiosum. After completing a 12-month course of intravenously administered liposomal amphotericin B (AmBisome; Fujisawa Healthcare) and itraconazole, the patient remained alive, in clinical remission, and symptom free.
Heath
John A
JA
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, 10021, USA.
Kiehn
Timothy E
TE
Brown
Arthur E
AE
LaQuaglia
Michael P
MP
Steinherz
Laurel J
LJ
Bearman
Gonzalo
G
Wong
May
M
Steinherz
Peter G
PG
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000382:microbiology*; D008297:Male; D010493:Pericarditis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D011014:Pneumonia / Q000188:drug therapy / Q000209:etiology*; D011775:Pythium
D000935:Antifungal Agents; D000666:Amphotericin B