Chronic meningitis by histoplasmosis: report of a child with acute myeloid leukemia.
Meningitis is a common evolution in progressive disseminated histoplasmosis in children, and is asymptomatic in many cases. In leukemia, the impaired of the T cells function can predispose to the disseminated form. The attributed mortality rate in this case is 20%-40% and the relapse rate is as high as 50%; therefore, prolonged treatment may be emphasized. We have described a child with acute myeloid leukemia (AML), that developed skin lesions and asymptomatic chronic meningitis, with a good evolution after prolonged treatment with amphotericin B deoxycholate followed by fluconazole.
Pereira
G H
GH
Department of Infectious Disease of Brigadeiro Hospital, São Paulo, SP, Brazil. ghpereira1@terra.com.br
Pádua
S S
SS
Park
M V F
MV
Muller
R P
RP
Passos
R M A
RM
Menezes
Y
Y
D000208:Acute Disease; D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003840:Deoxycholic Acid / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000627:therapeutic use; D006660:Histoplasmosis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D007951:Leukemia, Myeloid / Q000276:immunology* / Q000382:microbiology; D008297:Male; D016921:Meningitis, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome
D000935:Antifungal Agents; D004338:Drug Combinations; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination; D015725:Fluconazole