Multiple Pulmonary Aspergillomas Associated with Chronic Myelogenous Leukemia in Blastic Crisis

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Multiple pulmonary aspergillomas are a rare complication among a wide spectrum of pulmonary lesions due to aspergillosis reported in leukemic patients. In this paper a successfully treated case of multiple pulmonary aspergillomas in a patient with chronic myelogenous leukemia in blastic crisis was described, the diagnosis being confirmed by repeated positive sputum smears and cultures. He had a normal chest roentgenogram on admission and showed development of multiple pulmonary infiltrates, all of which subsequently evolved into cavities with mycetoma. Treatment with intravenous, intracavitary and nebulized amphotericin B was inferred to be successful in association with complete remission of his leukemia. Fever, rigors and hypokalemia were observed during a course of amphotericin B therapy. Multiple pulmonary aspergillomas should be kept in mind when a leukemic patient has developed unremitting fever and slowly progressive pulmonary infiltrates despite broadspectrum antibiotic therapy.