Successful voriconazole treatment of invasive pulmonary aspergillosis in a patient with acute biphenotypic leukemia

Koichiro Kobayashi, Masahiro Ogasawara, Yoshio Kiyama, Takayoshi Miyazono, Kumiko Kagawa, Kiyotoshi Imai, Teiichi Hirano, Naoki Kobayashi, Mitsune Tanimoto, Masaharu Kasai

Research output: Contribution to journalArticle

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 antibiotics 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 β-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.

Original languageEnglish
Pages (from-to)213-216
Number of pages4
JournalActa medica Okayama
Volume63
Issue number4
Publication statusPublished - Sep 2009

Keywords

  • Acute biphenotypic leukemia
  • Febrile neutropenia
  • Invasive pulmonary aspergillosis
  • Voriconazole
  • β-D-glucan

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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  • Cite this

    Kobayashi, K., Ogasawara, M., Kiyama, Y., Miyazono, T., Kagawa, K., Imai, K., Hirano, T., Kobayashi, N., Tanimoto, M., & Kasai, M. (2009). Successful voriconazole treatment of invasive pulmonary aspergillosis in a patient with acute biphenotypic leukemia. Acta medica Okayama, 63(4), 213-216.