Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Clinical History:
The patient was a 15 year old male with ALL, who had failed
chemotherapy induction 3 times, who developed a fever. He was started
on Gentamicin and Methicillin. Chest films at this time were
negative. Eight days after the onset of fever a chest film became
positive.
Clinical Physical Exam:
Febrile.
Clinical Labs:
The WBC count was 230/cubic millimeter.
Clinical Differential Diagnosis:
Lung infection
Imaging Findings:
Chest film taken 8 days after the fever began demonstrated a new
right middle lobe opacity. A chest CT exam from 13 days after the
fever began showed bilateral lung lesions.
Imaging Differential Diagnosis:
Aspergillosis.
Operative Findings:
The patient was started on Amphotericin. A needle aspiration of one
of the upper lobe lesions was performed.
Pathological Findings:
Pathological examination of the biopsy specimen revealed the presence
of Aspergillosis.
Final Diagnosis:
Aspergillosis
Follow-up and Prognosis:
The patient's WBC count increased to 3,000. Chest films and chest CT
exams began to show cavitation of the lesions.
Similar Cases:
Case 12,
Case 26
References:
Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
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