title: [Huge brain abscess and invasive pulmonary disease by fungal infection during chemotherapy for infantile acute myeloid leukemia].
abstract: The authors encountered a 7-year-old girl with a huge brain abscess and invasive pulmonary lesion due to fungus, who had been treated for acute myelogenous leukemia (AML). Although she was administered voriconazole to prevent fungal infection, she developed partial seizure and paralysis of the left side because of the huge brain abscess. Fungus culture and serum fungal markers, including Aspergillus antigen, were all negative. She underwent drainage and surgical resection of necrotic tissue after antifungal agents, including liposomal amphotericin B (L-AMB). Resection pathology revealed localized fungal infection, suspected as due to zygomycosis. The cerebral lesion reduced after the operation and the pulmonary lesion also vanished. We discontinued AML treatment because of the severe fungal infection; however, she has remained in continuous remission. Although Lipo-AMPH and itraconazole are comparatively effective for zygomycosis, progressive disseminated zygomycosis is extremely intractable. Our case underlines the feasibility and successful application of combined conventional antifungal agents and surgical resection in such a patient.
authors.affiliation: Department of Pediatrics, School of Medicine, Hokkaido University.
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Sato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Suzuki
authors.forename: Mizuho
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Kaneda
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nakagawa
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kobayashi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ariga
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001922:Brain Abscess / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008172:Lung Diseases, Fungal / Q000209:etiology*; D010243:Paralysis / Q000209:etiology; D012640:Seizures / Q000209:etiology; D020096:Zygomycosis / Q000150:complications*