1.Fungal discitis due to Aspergillus terreus in a patient with acute lymphoblastic leukemia.
Kyoung Un PARK ; Hye Seung LEE ; Chong Jai KIM ; Eui Chong KIM
Journal of Korean Medical Science 2000;15(6):704-707
We report a case of Aspergillus terreus discitis which developed in a patient with acute lymphoblastic leukemia following induction chemotherapy. A. terreus was isolated from sputum, one month earlier, but the physician did not consider it significant at the time. Magnetic resonance imaging study showed the involvement of L3-4, L4-5 and L5-S1 intervertebral discs. Etiology was established by means of histology and culturing a surgical specimen of disc materials. Our patient survived after a surgical debridement and amphotericin B administration with a total dose of 2.0 g. Discitis caused by Aspergillus terreus is a very rare event. A. terreus is one of the invasive Aspergillus species. The pathogenetic mechanism is discussed and the literature is reviewed.
Aspergillosis/surgery
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Aspergillosis/pathology
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Aspergillosis/microbiology*
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Aspergillosis/drug therapy
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Aspergillosis/complications
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Aspergillus/isolation & purification
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Aspergillus/classification
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Journal Article
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Discitis/surgery
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Discitis/pathology
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Discitis/microbiology*
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Discitis/drug therapy
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Human
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Intervertebral Disk/surgery
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Intervertebral Disk/pathology
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Intervertebral Disk/microbiology*
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Leukemia, Lymphocytic, Acute/microbiology
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Leukemia, Lymphocytic, Acute/drug therapy
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Leukemia, Lymphocytic, Acute/complications*
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Lumbar Vertebrae/surgery
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Lumbar Vertebrae/pathology
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Lumbar Vertebrae/microbiology*
2.Prognostic Factors Influencing Infection-related Mortality in Patients with Acute Leukemia in Korea.
Jin Hong YOO ; Su Mi CHOI ; Dong Gun LEE ; Jung Hyun CHOI ; Wan Shik SHIN ; Woo Sung MIN ; Chun Choo KIM
Journal of Korean Medical Science 2005;20(1):31-35
We retrospectively reviewed the medical records of 284 patients with neutropenic fever following chemotherapy for acute leukemia at the Catholic Hematopoietic Stem Cell Transplantation Center from January 1998 to December 1999, to identify prognostic factors for infection related mortality. Twenty-eight patients died of infections. There was no difference in median age, gender ratio, or underlying disease between the dying and surviving groups. Bacteria were the main pathogens following chemotherapy, and Gram positive organisms predominated in the dying group. Pneumonia and sepsis were the main causes of death. There were 72 cases of invasive fungal infection and their mortality was 27.8%. Invasive fungal infection and previous history of fungal infection were independent prognostic factors for outcome. Recovery from neutropenia was the significant protective factor for mortality. In conclusion, the prognostic factors identified in this study could be useful for deciding on more intensive treatment for those patients at greater risk of death. To our knowledge, this is the first Korean study delineating prognostic factors in acute leukemic patients with infectious complications.
Adolescent
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Adult
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Aged
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Bacterial Infections/complications/*mortality
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Cause of Death
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Female
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Humans
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Korea
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Leukemia
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Leukemia, Lymphocytic, Acute/complications/*microbiology/*mortality
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Leukemia, Myelocytic, Acute/complications/*microbiology/*mortality
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Male
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Middle Aged
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Morbidity
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Multivariate Analysis
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Mycoses/complications/mortality
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Neutropenia
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Pneumonia/complications/mortality
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Prognosis
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Retrospective Studies
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Sepsis/complications/mortality
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Survival Rate