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ID 31813
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Author
Kobayashi, Koichiro
Ogasawara, Masahiro
Kiyama, Yoshio
Miyazono, Takayoshi
Kagawa, Kumiko
Imai, Kiyotoshi
Hirano, Teiichi
Kobayashi, Naoki
Kasai, Masaharu
Abstract

A 23-year old woman with acute biphenotypic leukemia (ABL) complained of chest pain with cough, high fever and hemoptysis during induction chemotherapy, although she had been treated with anti-biotics and micafungin. We made a clinical diagnosis of invasive pulmonary aspergillosis (IPA) based on a consolidation in the right upper lung field on a chest radiograph as well as a high level of serum beta-D-glucan (with no evidence of tuberculosis and candidiasis). We changed her treatment from micafungin to voriconazole. Later, we discovered an air-crescent sign by CT scan that supported the diagnosis of IPA. Following voriconazole treatment, clinical symptoms ceased and abnormal chest shadows improved gradually and concurrently with a recovery of neutrophils. IPA must be considered in immunocompromised patients with pulmonary infiltrates who do not respond to broad-spectrum antibiotics. Serological tests and CT findings can aid in early diagnosis of IPA, which, along with treatment for IPA, will improve clinical outcomes.

Keywords
invasive pulmonary aspergillosis
voriconazole
acute biphenotypic leukemia
febrile neutropenia
?-D-glucan
Amo Type
Case Report
Published Date
2009-08
Publication Title
Acta Medica Okayama
Volume
volume63
Issue
issue4
Publisher
Okayama University Medical School
Start Page
213
End Page
216
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
File Version
publisher
Refereed
True
PubMed ID
Web of Science KeyUT