LEUCEMIA AGUDA BIFENOTIPICA PDF
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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Invasive Aspergillus flavus sinusitis: Sinusite invasiva por Aspergillus flavus: Here we report a case of invasive pansinusitis with proptosis of the right eye caused by Aspergillus flavus in an immunocompromised patient with acute biphenotypic leukemia without aggressive therapy response.
Leukemia; Aspergillus flavus ; Invasive sinusitis. After an initial complete remission of short duration he relapsed and underwent a second course of induction chemotherapy with metoxantrone and etoposide without response.
The patient was pancitopenic and with persistence of blasts; biphenotypic acute leukemia lineages myeloid and T-lymphoid demonstrated in a bone marrow biopsy. Physical examination showed edema, hyperemia and proptosis in the right eye with periorbital swelling laterally.
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Computed tomography CT scan of the head revealed opacification of the right maxillary, ethmoidal, sphenoidal and frontal sinuses. Leufemia erosion was also observed in the medial wall of the right maxillary sinus Fig. Lung CT scan revealed no abnormalities. Drained material of the right maxillary sinus was examined and revealed narrow, hyaline, septate hyphae elements, and characteristic dichotomous branching.
Fungal culture yielded Aspergillus flavus.
¿Cómo se clasifica la leucemia en niños?
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. Although precipitating antibody to A.
However, this aggressive treatment was unsuccessful, leukemia and fungal infection progressed, clinical status deteriorated and the patient showed neurological signs leading to death.
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. 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, 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.
Reports of sinusitis by A. In fact, in the largest series of fungal sinusitis described in the literature, A. Early diagnosis plays a great role in the treatment efficacy of fulminant sinusitis. Therapy is based in surgical remotion of the damaged tissue associated with antifungal therapy, where amphotericin B is the drug of choice 1.
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 agudda form.
Thus, in a series of five rhinocerebral mycosis cases, four leucrmia 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. 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 bifenotjpica and consequently reappearance of the disease.
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. Both reports emphasized the need of preventive measures as ventilation systems with high efficiency particulate airtype filters in rooms of patients included in a risk group 7,8.
Medicine Baltimore A case agyda and review of the literature.
Treatment with granulocyte transfusions. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Services on Demand Journal. How to cite this article.