Human Cytomegalovirus Pneumonia and Pulmonary Aspergillosis in a Patient with Acute Myelogenous Leukemia following Chemotherapy.
- Author:
Gi Beom KIM
1
;
Su Mi CHOI
;
Dong Gun LEE
;
Hae Rim KIM
;
Kye Won LEE
;
Kwan Woo NAM
;
Seung Ki KWOK
;
Dong Kyun SON
;
Jae Hyuck CHANG
;
Jung Hyun CHOI
;
Wan Shik SHIN
;
Chun Choo KIM
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. symonlee@cmc.cuk.ac.kr
- Publication Type:Case Report
- Keywords:
Cytomegalovirus pneumonia;
Leukemia;
Aspergillosis
- MeSH:
Adult;
Aspergillosis;
Consolidation Chemotherapy;
Cytomegalovirus*;
Drug Therapy*;
Fever;
Ganciclovir;
Giant Cells;
Hemoptysis;
HMGB1 Protein;
Humans*;
Hyphae;
Immunocompromised Host;
Immunoglobulins;
Intranuclear Inclusion Bodies;
Invasive Pulmonary Aspergillosis;
Leukemia;
Leukemia, Myeloid, Acute*;
Lung;
Mortality;
Necrosis;
Pneumonia*;
Pulmonary Aspergillosis*;
Radiography;
Shock, Septic;
Stem Cell Transplantation;
Thorax;
Tomography, X-Ray Computed;
Transplantation
- From:Korean Journal of Infectious Diseases
2002;34(4):261-266
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cytomegalovirus (CMV) pneumonia is one of the major causes of morbidity and mortality in immunocompromised patients such as transplant recipients. But CMV pneumonia is unusually reported among adults with leukemia who have not undergone transplantation. Because it is a cause of life-threatening pneumonia in adults with leukemia receiving potent immunosuppressive therapies, CMV has emerged as an important pathogen. We report a case of CMV pneumonia and invasive pulmonary aspergillosis in a patient with acute leukemia who have not undergone transplantation. A 31-year-old man with acute myelogenous leukemia developed high fever on day 9 of second consolidation chemotherapy. Six days later, chest radiography showed patchy consolidation with central cavity on right upper lung. Considering fungal pneumonia, amphoterin B was started, then fever was subsided. Chest CT showed necrotizing pneumonia with cavity formation in posterior segment of right upper lobe. Because of several episodes of hemoptysis, lobectomy was performed. Grossly, the area of focal necrosis with central cavity formation and multiple small interstitial nodules were observed. In the area of interstitial nodules, giant cells with intranuclear inclusion and perinuclear halo were found. In the area of focal necrosis, fungal hyphae with acute branching and septation were found. Ganciclovir and immunoglobulin were administered for CMV pneumonia. On day 62 of the chemotherapy, the patient discharged with improved symptoms. After several weeks, unrelated HLA-matched allogeneic stem cell transplantation was performed. On day 14 of transplantation, the patient died due to septic shock of unknown cause.
