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