Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
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:
The WBC count was 230/cubic millimeter.
Clinical Differential Diagnosis:
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:
The patient was started on Amphotericin. A needle aspiration of one of the upper lobe lesions was performed.
Pathological examination of the biopsy specimen revealed the presence of 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.
Case 12, Case 26
Follow us on Twitter @pedseducation and @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.