title: Successful treatment of tongue aspergillosis caused by Aspergillus flavus with liposomal amphotericin B in a child with acute lymphoblastic leukemia.
abstract: A 5-year-old boy with acute lymphoblastic leukemia and probable pulmonary aspergillosis developed a hard, protuberant, white-yellow and aggressive elongated lesion on the left side of his tongue during a febrile agranulocytopenic episode. Despite the use of broad-spectrum antibiotics and other supportive therapies, the lesion increased to about 2x4 cm in size within two days and became grey-black with an erythemateous, irregular line. Partial excision of the tongue was performed and isolates recovered from the tongue biopsy specimen were identified as Aspergillus flavus. An increase in the systemic dose (7 mg/kg/day) and local intraoral delivery of liposomal amphotericin B was successful in treating the patient and resulted in improved clinical and laboratory findings. Herein, we document the observation of tongue aspergillosis in a leukemic child with probable pulmonary aspergillosis receiving liposomal amphotericin B therapy and the successful treatment of tongue aspergillosis with an increased dose (7mg/kg) of liposomal amphotericin B. To the best of our knowledge, this is the youngest patient with documented intraoral aspergillosis and only the second case of tongue aspergillosis caused by Aspergillus flavus.
authors.affiliation: Department of Pediatrics, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey.
authors.forename: Ozcan
authors.initials: O
authors.lastname: Bor
authors.forename: Ener
authors.initials: E
authors.lastname: Cagri Dinleyici
authors.forename: Nuri
authors.initials: N
authors.lastname: Kiraz
authors.forename: Emine
authors.initials: E
authors.lastname: Dundar
authors.forename: Necat
authors.initials: N
authors.lastname: Akdeniz Akgun
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000382:microbiology; D001231:Aspergillus flavus / Q000302:isolation & purification*; D001706:Biopsy; D002675:Child, Preschool; D006801:Humans; D008297:Male; D008853:Microscopy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D014060:Tongue Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B