Emergency emicolectomy for intestinal primary Aspergillosis in acute myeloid leukemia

Imola, Manuela and Mianulli, Anna Maria and Pasini, Giuseppe and Santelmo, Carlotta and Drudi, Fabrizio and Fantini, Manuela and Corso, V. and Veneroni, L. and Ravaioli, Alberto (2012) Emergency emicolectomy for intestinal primary Aspergillosis in acute myeloid leukemia. Il giornale di chirurgia, 33 (3). pp. 74-76. ISSN 1971-145X

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Abstract

ntestinal aspergillosis is an infection with a very high death rate especially in leukemic patients. Here we describe a case of a 46 years old woman with acute myeloid leukemia (LAM M5) who developed intestinal primary aspergillosis. This patient was diagnosed with LAM M5 through bone marrow aspiration and bone biopsy in March 2004. Symptoms of the disease were slight persistent fever, weight loss, asthenia, anemia, thrombocytopenia,and leukocytosis with high number of blasts in peripheral blood. After induction chemotherapy with ICE (Ifosfamide, Carboplatin, Etoposide), she developed neutropenia and high fever without apparent infective foci. She was treated with empiric antibiotic therapy, nevertheless she developed an intense diarrhea and ileo-cecal distention. Diagnostic exams didn’t show signs of a focal lesion. Despite the change in antibiotic treatment and the transfusions of granulocytes and blood cells, the patient developed extremely critical conditions with persistence of neutropenia and abdominal distention. A surgical treatment was decided at the time. We treated the patient with a two steps surgical procedure. The first step was a right abdominal ileostomy followed by improvement of general conditions and then the second step a right colectomy. The histological morphology confirmed necrotizing colitis with Aspergillus ife. At that time , treatment with voriconazole was started. The general conditions of the patient improved rapidly and we were able to treat the patient with other medical anti-leukemic therapies. The patient is now cured and in healthy state. We obtained a good clinical result as only in other few cases described in literature.

Item Type:	Article
Uncontrolled Keywords:	Aspergillosis - Acute leukemia - Emicolectomy
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Nadia Del Gobbo
Date Deposited:	16 Jun 2016 09:43
Last Modified:	16 Jun 2016 09:43
URI:	http://eprints.bice.rm.cnr.it/id/eprint/7819

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