Complicated Pulmonary Aspergillosis with Pneumothorax and Pneumopericardium in a Child with Acute Lymphoblastic Leukemia

Abstract

Invasive aspergillosis is a fungal infection that is being observed increasingly in immunocompromised patients due to the use of more aggressive chemotherapeutic regimens. To our knowledge, no case of pneumothorax and pneumopericardium associated with invasive pulmonary aspergillosis has been reported to date. High-dose amphotericin B (1 to 1.5 mg/kg/day) is the treatment of choice, although severe side effects, especially hypokalemia, are very common. Itraconazole is considered to be a therapeutic alternative for invasive pulmonary aspergillosis in immunocompromised patients. A rare combination of pneumothorax and pneumopericardium associated with systemic aspergillosis in a child with acute lymphoblastic leukemia is described. Treatment with low-dose amphotericin B and itraconazole achieved complete resolution of the foregoing complications.