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CASE REPORT
Year : 2019  |  Volume : 8  |  Issue : 3  |  Page : 215-218

Unusual cause of intestinal perforation during induction chemotherapy in acute myeloid leukemia


Department of Medical Oncology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India

Correspondence Address:
Dr. Rajani Priya Yedla
Department of Medical Oncology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad - 500 082, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JDRNTRUHS.JDRNTRUHS_82_19

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Primary intestinal aspergillosis is a rare but serious infectious complication with a high morbidity and mortality in immunocompromised patients. We report a case of 47-year old male diagnosed with acute myeloid leukaemia and started on induction chemotherapy. On day 18 of chemotherapy, he presented with an acute abdomen and underwent emergency exploratory laparotomy. Histopathological specimen revealed transmural necrosis with fungal hyphae due to aspergillosis and voriconazole was started. Serum galactomannan test done was negative. In the post-induction chemotherapy, he attained complete remission and received three cycles of consolidation with high-dose cytarabine. With this case, we would like to emphasize that early recognition of primary intestinal aspergillosis is of the utmost importance because of its fulminant clinical course. It should be included in the differential diagnosis of neutropenic patients with sudden onset abdominal pain and ongoing fever, even in the absence of a positive serum galactomannan.


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