LEUCEMIA BIFENOTÍPICA AGUDA B/T: PRESENTACIÓN DE CASO CLÍNICO. BIPHENOTYPIC ACUTE LEUKEMIA: CASE REPORT. Article. Full-text available. vol número2 Lecciones aprendidas en la producción de materiales educativos en salud sexual y reproductiva, por promotores Leucemia bifenotípica aguda. Sinusite invasiva por Aspergillus flavus: relato de um caso associado a leucemia aguda bifenotípica. Melissa Orzechowski XavierI; Flávio de Mattos OliveiraII;.
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Medicine Baltimore Despite this aggressive treatment the outcome death is common, mainly due to the great period between the beginning of the disease and the therapy start, which permit the infection progress to a severe clinical form.
Both bifeenotipica emphasized the need bifennotipica preventive measures as ventilation systems with high efficiency particulate airtype filters in rooms of patients included in a risk group 7,8. Therapy is based in surgical remotion of the damaged tissue associated with antifungal therapy, where amphotericin B is the drug of choice 1.
Leukemia; Aspergillus flavus ; Invasive sinusitis. On the other hand, the development of a severe Aspergillus infection in a patient receiving a fungicide drug, amphotericin B as showed in our report, is very uncommon, since this antifungal should prevent the fungal growth and consequently reappearance of the disease. Although precipitating antibody to A. Biphenotypic acute leukemia is an uncommon type of leukemia, which probably arises in a multipotent progenitor cell with capability of differentiating along both myeloid and lymphoid lineages 3.
In neutropenic patients, as observed in our report, the presentation of an Aspergillus sinusitis is a fulminant invasive disease where rapidly progressive, gangrenous mucoperiosteitis is frequently fatal 1,4,5, In fact, in the largest series of fungal sinusitis described in the leucsmia, A.
Fungal sinusitis, commonly caused by the genus Aspergillusis frequently described in immunocompetent patients and in AIDS patients as a chronic indolent invasive sinusitis, characterized by a granulomatous response. Computed tomography CT scan of the head revealed opacification of the right maxillary, ethmoidal, sphenoidal and frontal sinuses.
A case report and review augda the literature. Drained material of the right bifeenotipica sinus was examined and revealed narrow, hyaline, septate hyphae elements, and characteristic dichotomous branching.
However, a very similar case was described in the literature 8 suggesting that only the antifungal chemotherapy is not efficient in the control of a fungal infection in neutropenic patients. Bone erosion was also observed in the medial wall of the right maxillary sinus Fig. The patient was pancitopenic and with persistence of blasts; biphenotypic acute leukemia lineages myeloid and T-lymphoid demonstrated in a bone marrow biopsy.
Sinusite invasiva por Aspergillus flavus: Microscopic examination of the biopsy obtained from the sinus mucosa showed chronic inflammation and invasion of the submucosa with numerous fungal hyphae consistent with Aspergillus Fig.
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All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Invasive Aspergillus flavus sinusitis: However, this aggressive treatment was unsuccessful, leukemia and fungal infection progressed, clinical status deteriorated and the patient showed neurological signs leading to death. Lung CT scan revealed no abnormalities.
Fungal culture yielded Aspergillus flavus. Treatment leucekia granulocyte transfusions.
Reports of sinusitis by A. Services on Demand Journal.
Thus, in a series of five rhinocerebral mycosis cases, four patients died in spite of the amphotericin B therapy 7as well as in the largest series of fungal sinusitis where nine from the 17 patients evoluted to death 2. After an initial complete remission of short duration he relapsed and underwent a second course of induction chemotherapy with metoxantrone and etoposide without response.
Physical examination showed edema, hyperemia and proptosis in the right eye with periorbital swelling laterally. Here we report a case of invasive pansinusitis with proptosis of lecemia right eye caused by Aspergillus flavus in an immunocompromised patient with acute biphenotypic leukemia without aggressive therapy response.
Early diagnosis plays a great role in the treatment efficacy of fulminant sinusitis.