Rhinocerebral Mucormycosis Developed in a Boy with Refractory Acute Lymphoblastic Leukemia.
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We report a case of rhinocerebral mucormycosis that developed after multi-drug chemotherapy for relapsed acute lymphoblastic leukemia (ALL). A4-year-old boy with common ALL relapsed hematologically and received a chemotherapy consisting of prednisolone, etoposide, cytosine arabinoside and mitoxantrone. Several days after persistent high fever unresponsive to antibiotics, his left cheek became reddened and swollen, and massive destruction of his hard palate was noted. Pathological examination of the palate revealed the infiltration of fungi which showed characteristics of Mucorales. We started intravenous amphotericin-B therapy, but due to its severe toxicity, had to change it to 5-fluorocytosine and fluconazole. The granulocyte-colony stimulating factor therapy was also adopted for persistent severe neutropenia. However, despite all efforts, he died 5 months after diagnosis of mucormycosis. An intensive prophylaxis is required to prevent lethal fungal infections including mucormycosis during severe neutropenia after combined chemotherapy.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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