Case Report

Korean J Hematol 2005; 40(3):

Published online September 30, 2005

https://doi.org/10.5045/kjh.2005.40.3.167

© The Korean Society of Hematology

완전관해 상태의 급성전골수구백혈병 환자에서 발생한 치명적인 다발성 뇌 아스페르길루스증 1예

송명준, 이동건, 서석민, 김원철, 빈홍건, 우현영, 전연주, 조석구, 손병철, 이혜경

가톨릭대학교 의과대학 감염내과학교실, 혈액 종양내과학교실, 신경외과학교실, 임상병리학교실

A Case of Fatal Multiple Cerebral Aspergillosis in a Patient with Acute Promyelocytic Leukemia during Complete Remission

Myoung Joon Song, Dong, Gun Lee, Suk Min Seo, Won Chul Kim, Hong Gern Bin, Hyun Young Woo, Yeon Joo Jun, Seok Goo Cho, Byung Cheol Son, Hae Kyung Lee

Division of, Infection and, Hematology, Department of Internal Medicine, Neurosurgery, Clinical Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Cerebral aspergillosis accounts for about 10% of all the cases of invasive aspergillosis. The brain is the only infected site in less than 10% of cases. The patients at high risk for of aspergillosis are immunocompromised patients such as those in a neutropenic state after chemotherapy, AIDS and etc. We experienced a case of cerebral aspergillosis in a patient with acute leukemia that was in complete remission. The patient visited our hospital's ER due to nasal bleeding, and then he was quickly diagnosed as having acute promyelocytic leukemia. After the first induction chemotherapy, he achieved a complete remission. Loss of consciousness developed on day 31 after chemotherapy. High signal intensity in the right temporooccipital lobe and multiple nodular lesions in both cerebral hemisphereswere observed on the brain MRI. Stereotaxic biopsy showed septate aspergillus hyphae in the brain specimen. Despite of the use of amphotericin B deoxycholate, the patient died of recurrent grand mal seizure and multiple organ failure.

Keywords Aspergillosis, Brain infarction, Acute promyelocytic leukemia, Complete remission

Article

Case Report

Korean J Hematol 2005; 40(3): 167-171

Published online September 30, 2005 https://doi.org/10.5045/kjh.2005.40.3.167

Copyright © The Korean Society of Hematology.

완전관해 상태의 급성전골수구백혈병 환자에서 발생한 치명적인 다발성 뇌 아스페르길루스증 1예

송명준, 이동건, 서석민, 김원철, 빈홍건, 우현영, 전연주, 조석구, 손병철, 이혜경

가톨릭대학교 의과대학 감염내과학교실, 혈액 종양내과학교실, 신경외과학교실, 임상병리학교실

A Case of Fatal Multiple Cerebral Aspergillosis in a Patient with Acute Promyelocytic Leukemia during Complete Remission

Myoung Joon Song, Dong, Gun Lee, Suk Min Seo, Won Chul Kim, Hong Gern Bin, Hyun Young Woo, Yeon Joo Jun, Seok Goo Cho, Byung Cheol Son, Hae Kyung Lee

Division of, Infection and, Hematology, Department of Internal Medicine, Neurosurgery, Clinical Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Cerebral aspergillosis accounts for about 10% of all the cases of invasive aspergillosis. The brain is the only infected site in less than 10% of cases. The patients at high risk for of aspergillosis are immunocompromised patients such as those in a neutropenic state after chemotherapy, AIDS and etc. We experienced a case of cerebral aspergillosis in a patient with acute leukemia that was in complete remission. The patient visited our hospital's ER due to nasal bleeding, and then he was quickly diagnosed as having acute promyelocytic leukemia. After the first induction chemotherapy, he achieved a complete remission. Loss of consciousness developed on day 31 after chemotherapy. High signal intensity in the right temporooccipital lobe and multiple nodular lesions in both cerebral hemisphereswere observed on the brain MRI. Stereotaxic biopsy showed septate aspergillus hyphae in the brain specimen. Despite of the use of amphotericin B deoxycholate, the patient died of recurrent grand mal seizure and multiple organ failure.

Keywords: Aspergillosis, Brain infarction, Acute promyelocytic leukemia, Complete remission

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