Acute aspergillosis and lymphocytic leukaemia

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Case number: 

1

Summary: 

This 50 year old Caucasian man was diagnosed with acute lymphocytic leukaemia (ALL) with CNS involvement in early February. He was treated with chemotherapy with vincristine, daunoblastin, and cytarabin and intrathecal methotrexate. By the end of February,while neutropenic, he developed definite pulmonary aspergillosis (based on transbronchial biopsy), later confirmed as disseminated disease on autopsy. His disease was refractory to amphotericin B deoxycholate for 6 days, liposomal amphotericin B for 2 days, and amphotericin B lipid complex for 2 days (progression of disease with the development of new nodules on chest CT). The patient was treated with caspofungin for 11 days, but he expired from respiratory failure.

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Case history