Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain

Unal, Sule; ÇETIN, MUALLA; Tavil, Betul; GÜMRÜK, FATMA; ELMAS, Selin Aytaç; UÇKAN ÇETINKAYA, DUYGU; HALİLOĞLU, Mithat; KUŞKONMAZ, BÜLENT BARIŞ

Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain

Şule ÜNAL, (Hacettepe Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

BÜLENT BARIŞ KUŞKONMAZ, (Hacettepe Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Betül TAVİL, (Hacettepe Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Selin Aytaç ELMAS, (Hacettepe Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Duygu Uçkan ÇETİNKAYA, (Hacettepe Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Mualla ÇETİN, (Hacettepe Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Mithat HALİLOĞLU, (Hacettepe Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Ankara, Türkiye)

Fatma GÜMRÜK (Hacettepe Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Ankara, Türkiye)

Turkish Journal of Hematology

1 1

Yıl: 2010 Cilt: 27 Sayı: 1 Sayfa Aralığı: 34 - 37 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain

Öz:

Göğüs ağrIsI yakInmasI ile başvuran dört pediatrik akut lenfoblastik lösemi olgusu pulmoner fungal enfeksiyon tanIsI almIştIr.Düz grafilerinde pozitif bulgu olmayan bu hastalarIn, bilgisayarlI tomografi incelemelerinde pulmoner noduler opasifikasyonlarve bazI hastalarda kavitasyonlar pulmoner enfeksiyon yönünden uyarIcI olmuştur. Bu deneyimimiz lösemili hastalarda pulmonerinvasif enfeksiyonun ilk yakInmasInIn göğüs ağrIsI olabilecegine, düz grafiler normal olsa bile bu hastalarda bilgisayarlI tomo- grafinin erken yapIlmasI ile fungal enfeksiyonun erken tanI ve tedavi edilmesinin önemine dikkat cekmektedir.

Anahtar Kelime:

Konular: Hematoloji

Göğüs ağrısı ile başvuran pediatrik akut lenfoblastik lösemi olgularında kemoterapi sırasında ya da kök hücre nakli sonrası gelişen pulmoner fungal enfeksiyonun bilgisayarlı tomografi ile erken tayini

Öz:

We describe herein four children with acute lymphoblastic leukemia who were diagnosed as pulmonary fungal infection afterpresenting with chest pain. The plain radiologic evaluations failed to reveal any positive findings, whereas computerizedtomography (CT) scanning showed nodular opacification with or without cavitation. This experience suggests that chest pain maybe an initial symptom of an invasive fungal infection in patients with leukemia, and CT scan of the lungs should be performedurgently for the early diagnosis and treatment, despite normal plain X-rays.

Anahtar Kelime:

Konular: Hematoloji

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık

1. Maertens J, Meersseman W, Van Bleyenbergh P. New therapies for fungal pneumonia. Curr Opin Infect Dis 2009;22:183-90.
2. Subira M, Martino R, Franquet T, Puzo C, Altés A, Sureda A, Brunet S, Sierra J. Invasive pulmonary aspergillosis in patients with hematologic malignancies: survival and prognostic factors. Haematologica 2002;87:528-34.
3. Martino P, Girmenia C, Venditti M, Micozzi A, Gentile G, Raccah R, Martinelli E, Rendina E, Mandelli F. Spontaneous pneumothorax complicating pulmonary mycetoma in patients with acute leukemia. Rev Infect Dis 1990;12:611-7.
4. Girmenia C, Donato V, Iori AP, Martino P. Spontaneous pneumothorax in patients with leukemia. Ann Intern Med 1993;118:707-8.
5. Yetgin S, Olgar S, Aras T, Cetin M, Düzova A, Beylergil V, Akhan O, Oúuz O, Saraçbaýi O. Evaluation of kidney damage in patients with acute lymphoblastic leukemia in long-term follow-up: value of renal scan. Am J Hematol 2004;77:132-9.
6. Eckert C, Biondi A, Seeger K, Cazzaniga G, Hartmann R, Beyermann B, Pogodda M, Proba J, Henze G. Prognostic value of minimal residual disease in relapsed childhood acute lymphoblastic leukaemia. Lancet 2001;358:1239-41.
7. Fleischhack G, Hasan C, Graf N, Mann G, Bode U. IDA-FLAG (idarubicin, fludarabine, cytarabine, G-CSF), an effective remission-induction therapy for poor-prognosis AML of childhood prior to allogeneic or autologous bone marrow transplantation: experiences of a phase II trial. Br J Haematol 1998;102:647-55.
8. Gorelik O, Cohen N, Shpirer I, Almoznino-Sarafian D, Alon I, Koopfer M, Yona R, Modai D. Fatal haemoptysis induced by invasive pulmonary aspergillosis in patients with acute leukaemia during bone marrow and clinical remission: report of two cases and review of the literature. J Infect 2000;41:277-82.
9. Todeschini G, Murari C, Bonesi R, Pizzolo G, Verlato G, Tecchio C, Meneghini V, Franchini M, Giuffrida C, Perona G, Bellavite P. Invasive aspergillosis in neutropenic patients: rapid neutrophil recovery is a risk factor for severe pulmonary complications. Eur J Clin Invest 1999;29:453-7.
10. Hovi L, Saarinen-Pihkala UM, Vettenranta K, Saxen H. Invasive fungal infections in pediatric bone marrow transplant recipients: single center experience of 10 years. Bone Marrow Transplant 2000;26:999-1004.
11. Schuster F, Moelter C, Schmid I, Graubner UB, Kammer B, Belohradsky BH, Führer M. Successful antifungal combination therapy with voriconazole and caspofungin. Pediatr Blood Cancer 2005;44:682-5.
12. Serrano-Gonzalez A, Merino-Arribas JM, Ruiz-Lopez MJ, Casado-Flores J. Invasive pulmonary aspergillosis with pneumopericardium and pneumothorax. Pediatr Radiol 1992;22:601-2.
13. Reichenberger F, Habicht J, Kaim A, Dalquen P, Bernet F, Schläpfer R, Stulz P, Perruchoud AP, Tichelli A, Gratwohl A, Tamm M. Lung resection for invasive pulmonary aspergillosis in neutropenic patients with hematologic diseases. Am J Respir Crit Care Med 1998;158:885-90.
14. Ulusakarya A, Chachaty E, Vantelon JM, Youssef A, Tancrède C, Pico JL, Bourhis JH, Fenaux P, Munck JN. Surveillance of Aspergillus galactomannan antigenemia for invasive aspergillosis by enzyme-linked immunosorbent assay in neutropenic patients treated for hematological malignancies. Hematol J 2000;1:111-6.
15. Ascioglu S, Rex JH, de Pauw B, Bennett JE, Bille J, Crokaert F, Denning DW, Donnelly JP, Edwards JE, Erjavec Z, Fiere D, Lortholary O, Maertens J, Meis JF, Patterson TF, Ritter J, Selleslag D, Shah PM, Stevens DA, Walsh TJ.; Invasive Fungal Infections Cooperative Group of the European Organization for Research and Treatment of Cancer; Mycoses Study Group of the National Institute of Allergy and Infectious Diseases. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 2002;34:7-14.
16. Brook O, Guralnik L, Hardak E, Oren I, Sprecher H, Zuckerman T, Engel A, Yigla M. Radiological findings of early invasive pulmonary aspergillosis in immune-compromised patients. Hematol Oncol 2009;27:102-6.

APA	Unal S, KUŞKONMAZ B, Tavil B, ELMAS S, UÇKAN ÇETINKAYA D, ÇETIN M, HALİLOĞLU M, GÜMRÜK F (2010). Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. , 34 - 37.
Chicago	Unal Sule,KUŞKONMAZ BÜLENT BARIŞ,Tavil Betul,ELMAS Selin Aytaç,UÇKAN ÇETINKAYA DUYGU,ÇETIN MUALLA,HALİLOĞLU Mithat,GÜMRÜK FATMA Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. (2010): 34 - 37.
MLA	Unal Sule,KUŞKONMAZ BÜLENT BARIŞ,Tavil Betul,ELMAS Selin Aytaç,UÇKAN ÇETINKAYA DUYGU,ÇETIN MUALLA,HALİLOĞLU Mithat,GÜMRÜK FATMA Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. , 2010, ss.34 - 37.
AMA	Unal S,KUŞKONMAZ B,Tavil B,ELMAS S,UÇKAN ÇETINKAYA D,ÇETIN M,HALİLOĞLU M,GÜMRÜK F Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. . 2010; 34 - 37.
Vancouver	Unal S,KUŞKONMAZ B,Tavil B,ELMAS S,UÇKAN ÇETINKAYA D,ÇETIN M,HALİLOĞLU M,GÜMRÜK F Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. . 2010; 34 - 37.
IEEE	Unal S,KUŞKONMAZ B,Tavil B,ELMAS S,UÇKAN ÇETINKAYA D,ÇETIN M,HALİLOĞLU M,GÜMRÜK F "Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain." , ss.34 - 37, 2010.
ISNAD	Unal, Sule vd. "Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain". (2010), 34-37.

APA	Unal S, KUŞKONMAZ B, Tavil B, ELMAS S, UÇKAN ÇETINKAYA D, ÇETIN M, HALİLOĞLU M, GÜMRÜK F (2010). Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. Turkish Journal of Hematology, 27(1), 34 - 37.
Chicago	Unal Sule,KUŞKONMAZ BÜLENT BARIŞ,Tavil Betul,ELMAS Selin Aytaç,UÇKAN ÇETINKAYA DUYGU,ÇETIN MUALLA,HALİLOĞLU Mithat,GÜMRÜK FATMA Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. Turkish Journal of Hematology 27, no.1 (2010): 34 - 37.
MLA	Unal Sule,KUŞKONMAZ BÜLENT BARIŞ,Tavil Betul,ELMAS Selin Aytaç,UÇKAN ÇETINKAYA DUYGU,ÇETIN MUALLA,HALİLOĞLU Mithat,GÜMRÜK FATMA Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. Turkish Journal of Hematology, vol.27, no.1, 2010, ss.34 - 37.
AMA	Unal S,KUŞKONMAZ B,Tavil B,ELMAS S,UÇKAN ÇETINKAYA D,ÇETIN M,HALİLOĞLU M,GÜMRÜK F Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. Turkish Journal of Hematology. 2010; 27(1): 34 - 37.
Vancouver	Unal S,KUŞKONMAZ B,Tavil B,ELMAS S,UÇKAN ÇETINKAYA D,ÇETIN M,HALİLOĞLU M,GÜMRÜK F Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain. Turkish Journal of Hematology. 2010; 27(1): 34 - 37.
IEEE	Unal S,KUŞKONMAZ B,Tavil B,ELMAS S,UÇKAN ÇETINKAYA D,ÇETIN M,HALİLOĞLU M,GÜMRÜK F "Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain." Turkish Journal of Hematology, 27, ss.34 - 37, 2010.
ISNAD	Unal, Sule vd. "Early detection of pulmonary fungal infection by CT scan in pediatric ALL patients under chemotherapy orin post-transplantation period with primary complaint of chest pain". Turkish Journal of Hematology 27/1 (2010), 34-37.