A case of acute myelocytic leukemia that developed Aspergillus liver abscess without pulmonary involvement

• Published in: Kanzo Vol. 37; no. 9; pp. 507 - 512
• Main Authors: MASUI, Kazuhiro, KOBAYASHI, Yozo, MATSUI, Yuuji, YOSHIKAWA, Masahide, SAKAOTO, Takemi, FUKUI, Hiroshi, KURIYAMA, Shigeki, YOSHIKAWA, Masaaki, HOPPOU, Kazushige, MORIMURA, Masafumi, OKAMOTO, Shingo
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Hepatology 1996
• ISSN: 0451-4203; 1881-3593
• DOI: 10.2957/kanzo.37.507

A 53-year-old female with pancytopenia was admitted to our hospital in June, 1994. She was diagnosed as acute myelocytic leukemia (M2 according to the FAB classification) by specimens of bone marrow puncture, and treated with BHAC-DMP (enocitabine, daunorubicin, mercaptopurine, prednisolone) regimen. She developed spiking fever at a nadir period of granulocytes during the induction chemotherapy, and high fever persisted even after achieving complete remission despite anti-bacterial and-fungal treatment. Repeated blood cultures gave negative results, and there was no evidence of local infection, Seventeen days after the beginning of high fever, elevation of biliary tract enzymes and transaminases was observed, and subsequent abdominal ultrasonography and computed tomography revealed multiple liver abscess. Specimens of initial liver biopsy showed that the liver abscess was pyogenic, but failed to define an infectious etiology. Second trial of liver biopsy, however, gave the evidence of Aspergillus infection. Anti-fungal treatment was resumed, and the liver abscess gradually reduced with improvement of inflammatory indices probably due to her immunological betterment. To our knowledge, this is the first report of a case that developed Aspergillus liver abscess without pulmonary involvement and diagnosed by liver biopsy.