Diagnostic and Therapeutic Challenge Caused by <i>Candida albicans</i> and <i>Aspergillus</i> spp. Infections in a Pediatric Patient as a Complication of Acute Lymphoblastic Leukemia Treatment: A Case Report and Literature Review

Fungal infections constitute a significant challenge and continue to be a predominant cause of treatment failure in pediatric leukemia cases. Despite the implementation of antifungal prophylaxis, these infections contribute to approximately 20% of cases in children undergoing treatment for acute lym...

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Main Authors: Natalia Zaj, Weronika Kopyt, Emilia Kamizela, Julia Zarychta, Adrian Kowalczyk, Monika Lejman, Joanna Zawitkowska
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Pathogens
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Online Access:https://www.mdpi.com/2076-0817/13/9/772
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Summary:Fungal infections constitute a significant challenge and continue to be a predominant cause of treatment failure in pediatric leukemia cases. Despite the implementation of antifungal prophylaxis, these infections contribute to approximately 20% of cases in children undergoing treatment for acute lymphoblastic leukemia (ALL). The aim of this study is to highlight the diagnostic and therapeutic challenges associated with invasive fungal infections (IFIs). We also present a review of the epidemiology, risk factors, treatment, and a clinical presentation of IFI in patients with ALL. This case report details the clinical course of confirmed <i>Candida albicans</i> (<i>C. albicans</i>) and <i>Aspergillus</i> spp. infections during the consolidation phase of ALL treatment in a 5-year-old pediatric patient. This male patient did not experience any complications until Day 28 of protocol II. Then, the patient’s condition deteriorated. Blood culture detected the growth of <i>C. albicans</i>. Despite the implementation of targeted therapy, the boy’s condition did not show improvement. The appearance of respiratory symptoms necessitated a computed tomography (CT) of the chest, which revealed multiple nodular densities atypical for <i>C. albicans</i> etiology. In spite of ongoing antifungal treatment, the lesions depicted in the CT scans showed no regression. A lung biopsy ultimately identified <i>Aspergillus</i> species as the source of the infection. Overcoming fungal infections poses a considerable challenge; therefore, an accurate diagnosis and the prompt initiation of targeted therapy are crucial in managing these infections in patients with leukemia.
ISSN:2076-0817