Published online May 6, 2014. doi: 10.5315/wjh.v3.i2.44
Revised: December 23, 2013
Accepted: January 17, 2014
Published online: May 6, 2014
An 11-year-old boy with acute lymphocytic leukemia (ALL) contracted disseminated candidiasis during induction therapy, which was complicated with rupture of a fungal cranial aneurysm. Ventricular drainage and coil embolization of a residual aneurysm in combination with intensive antifungal therapy rescued the patient. Although clinical improvement was achieved, high fever and elevated levels of C-reactive protein and β-D-glucan continued for more than 10 mo. One year later, the ALL relapsed during maintenance therapy with methotrexate and 6-mercaptopurine. After salvage chemotherapy, the patient received unrelated bone marrow transplantation (BMT) in a non-complete remission condition and survived. During subsequent chemotherapy and BMT, no recurrence of the fungal infection was observed under the prophylactic anti-fungal therapy with micafungin.
Core tip: Chronic disseminated candidiasis and resulting fungal intracranial aneurysm is a life-threatening complication during the induction therapy of leukemia with a poor survival rate. However, intensive and patient anti-fungal treatment made the patient receive unrelated bone marrow transplantation successfully.