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ID 31813
JaLCDOI
フルテキストURL
著者
Kobayashi, Koichiro Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Ogasawara, Masahiro Department of Hematology, Sapporo Hokuyu Hospital
Kiyama, Yoshio Department of Hematology, Sapporo Hokuyu Hospital
Miyazono, Takayoshi Department of Hematology, Sapporo Hokuyu Hospital
Kagawa, Kumiko Department of Hematology, Sapporo Hokuyu Hospital
Imai, Kiyotoshi Department of Hematology, Sapporo Hokuyu Hospital
Hirano, Teiichi Department of Hematology, Sapporo Hokuyu Hospital
Kobayashi, Naoki Department of Hematology, Sapporo Hokuyu Hospital
Tanimoto, Mitsune Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kasai, Masaharu Department of Hematology, Sapporo Hokuyu Hospital
抄録

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.

キーワード
invasive pulmonary aspergillosis
voriconazole
acute biphenotypic leukemia
febrile neutropenia
?-D-glucan
Amo Type
Case Report
発行日
2009-08
出版物タイトル
Acta Medica Okayama
63巻
4号
出版者
Okayama University Medical School
開始ページ
213
終了ページ
216
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
論文のバージョン
publisher
査読
有り
PubMed ID
Web of Sience KeyUT