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Fungal Mycotic Aneurysm in a Case of Acute Lymphoblastic Leukemia

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Abstract

We report a case of a 15-year old boy who was managed as a case of B cell lymphoblastic leukaemia with the modified BFM 90 protocol. During the induction phase, he developed febrile neutropenia with sino-pulmonary fungal infection confirmed on histopathology. He developed left sided hemiparesis during in-hospital management of febrile neutropenia. Neuroimaging revealed 9.6 × 8.4 mm round well defined aneurysm arising from right cortical artery in distal middle cerebral artery territory. He underwent fronto-temporo-parietal craniectomy with evacuation of the hematoma and excision of the aneurysm. Histopathological examination of excised aneurysmal specimen grew same species of fungus as was cultured from nasal scraping. He recovered fully in next 6 months with minimal residual focal neurological deficits. Presently he is in maintenance phase chemotherapy. We presented this case to illustrate a rare complication of ALL therapy with mycotic aneurysm secondary to invasive fungal infection treated successfully.

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References

  1. Osler W (1885) The Gulstonian lectures, on malignant endocarditis. Br Med J 1(1264):577–579

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Allen LM, Fowler AM, Walker C, Derdeyn CP, Nguyen BV, Hasso AN et al (2013) Retrospective review of cerebral mycotic aneurysms in 26 patients: focus on treatment in strongly immunocompromised patients with a brief literature review. AJNR Am J Neuroradiol 34(4):823–827

    Article  CAS  PubMed  Google Scholar 

  3. Chimparlee N, Jittapiromsak P, Tantivatana J, Chattranukulchai P (2014) Classical complication of infective endocarditis: ruptured, large mycotic cerebral aneurysm. BMJ Case Rep 2014:bcr2013202275

    Article  PubMed  PubMed Central  Google Scholar 

  4. Chandrikakumari K, Giot JB, de Leval L, Creemers E, Leonard P, Mukeba D et al (2008) Report of a case of Streptococcus agalactiae mycotic aneurysm and review of the literature. Int J Surg Pathol 16(3):314–319

    Article  PubMed  Google Scholar 

  5. Mettananda KC, De Silva ST, Premawardhena AP (2010) Mycotic aneurysm of the descending aorta due to Aspergillus species. Ceylon Med J 55(1):20–21

    Article  CAS  PubMed  Google Scholar 

  6. Suzuki K, Iwabuchi N, Kuramochi S, Nakanoma J, Suzuki Y, Serizawa H et al (1995) Aspergillus aneurysmof the middle cerebral artery causing a fatal subarachnoid hemorrhage. Intern Med 34(6):550–553

    Article  CAS  PubMed  Google Scholar 

  7. Morriss FH Jr, Spock A (1970) Intracranial aneurysm secondary to mycotic orbital and sinus infection. Report of a case implicating penicillium as an opportunistic fungus. Am J Dis Child 119(4):357–362

    Article  PubMed  Google Scholar 

  8. Oderich GS, Panneton JM, Bower TC, Cherry KJ Jr, Rowland CM, Noel AA et al (2001) Infected aortic aneurysms: aggressive presentation, complicated early outcome, but durable results. J Vasc Surg 34(5):900–908

    Article  CAS  PubMed  Google Scholar 

  9. Takeshita M, Izawa M, Kubo O, Tanikawa T, Onda H, Wanifuchi H et al (1992) Aspergillotic aneurysm formation of cerebral artery following neurosurgical operation. Surg Neurol 38(2):146–151

    Article  CAS  PubMed  Google Scholar 

  10. Komatsu Y, Narushima K, Kobayashi E, Tomono Y, Nose T (1991) Aspergillus mycotic aneurysm–case report. Neurol Med Chir (Tokyo) 31(6):346–350

    Article  CAS  Google Scholar 

  11. AbdelAzim TA (2005) Infected aortic aneurysms. Acta Chir Belg 105(5):482–486

    Article  CAS  PubMed  Google Scholar 

  12. Kikuchi K, Watanabe K, Sugawara A, Kowada M (1985) Multiple fungal aneurysms: report of a rare case implicating steroid as predisposing factor. Surg Neurol 24(3):253–259

    Article  CAS  PubMed  Google Scholar 

  13. Zingale A, Chiaramonte I, Albanese V, Tropea R (1997) Infected cerebral hemorrhage by ruptured infectious anterior communicating artery giant aneurysm in a patient with T cell acute lymphoblastic leukemia. Case report. J Neurosurg Sci 41(4):395–400

    CAS  PubMed  Google Scholar 

  14. Minnerup J, Schilling M, Wersching H, Olschlager C, Schabitz WR, Niederstadt T et al (2008) Development of a mycotic aneurysm within 4 days. Neurology 71(21):1745

    Article  CAS  PubMed  Google Scholar 

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This study was not funded by any institution or authority.

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Correspondence to Pankaj Malhotra.

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This article does not contain any studies with animals performed by any of the authors. This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from the participant included in the study.

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Sahu, K.K., Yanamandra, U., Dhawan, R. et al. Fungal Mycotic Aneurysm in a Case of Acute Lymphoblastic Leukemia. Indian J Hematol Blood Transfus 32 (Suppl 1), 32–37 (2016). https://doi.org/10.1007/s12288-015-0574-6

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  • DOI: https://doi.org/10.1007/s12288-015-0574-6

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