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M9650448.TXT
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1996-03-09
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Document 0448
DOCN M9650448
TI First case of disseminated Mycobacterium avium infection following
chemotherapy for childhood acute myeloid leukemia.
DT 9605
AU Claass A; Claviez A; Westphal E; Rusch-Gerdes S; Schneppenheim R;
Institut fur Immunologie, Christian-Albrechts-Universitat,; Kiel,
Germany.
SO Infection. 1995 Sep-Oct;23(5):301-2. Unique Identifier : AIDSLINE
MED/96128592
AB A 14-year-old girl of Indian origin with acute myeloid leukemia (AML) is
presented, who was diagnosed at the age of twelve. Antileukemic
chemotherapy had to be discontinued after 6 weeks because of persistent
high fever and the emergence of liver and spleen abscesses. Serologic
and biopsy findings were consistent with disseminated candidiasis;
however, a liver biopsy also revealed granulomatous lesions with caseous
degeneration. No acid-fast bacilli could be detected. Upon antifungal
treatment the patient's condition improved, but fever spells and high
inflammatory blood parameters persisted. One year after the diagnosis of
AML was established, Mycobacterium avium was cultured from bone marrow
aspirates. The patient's cellular immunity was severely compromised at
that time as reflected by the marked depression of T-lymphocyte counts,
in particular of CD4-positive cells. HIV and other lymphotropic virus
infections were subsequently excluded. After 5 months of specific
treatment the patient recovered from mycobacterial infection and remains
in first remission of AML. Opportunistic infections have rarely been
diagnosed in oncologic patients to date, while data on T-cell function
in AML is sparse. Fever of unknown origin should prompt the search for
infectious agents unusual to date in this patient group.
DE Adolescence Case Report Female Human Leukemia, Myelomonocytic,
Acute/*COMPLICATIONS/DRUG THERAPY Mycobacterium avium-intracellulare
Infection/*COMPLICATIONS/ MICROBIOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).