Pulmonary tuberculosis presenting as fever without source in a pediatric patient with acute lymphoblastic leukemia.
Children who undergo treatment for malignancies are at high for infection with both typical and opportunistic pathogens. Fever in these children prompts extensive evaluation and empiric treatment with broad-spectrum antimicrobials. In the United States (US), tuberculosis is an infrequently reported cause of fever in the pediatric cancer patient and has not been well described. In this report we describe a case of primary pulmonary tuberculosis (TB) in a boy with precursor B-cell acute lymphoblastic leukemia (ALL) and review the pertinent literature.
Lancioni
Christina
C
Division of Pediatric Infectious Diseases, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio 44106, USA. christina.lancioni@uhhospitals.org
LaBeaud
A Desiree
AD
Esper
Frank
F
Abughali
Nazha
N
Auletta
Jeffery
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016358:Contact Tracing; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000008:administration & dosage / Q000627:therapeutic use; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D016867:Immunocompromised Host; D007538:Isoniazid / Q000008:administration & dosage / Q000627:therapeutic use; D008231:Lymphopenia / Q000139:chemically induced; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011013:Pneumonectomy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D011718:Pyrazinamide / Q000008:administration & dosage / Q000627:therapeutic use; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery / Q000635:transmission; D014750:Vincristine / Q000008:administration & dosage
D000995:Antitubercular Agents; D003561:Cytarabine; D011718:Pyrazinamide; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D017963:Azithromycin; D004977:Ethambutol; D003520:Cyclophosphamide; D007538:Isoniazid; D012293:Rifampin