Abstract
The patient was a 39-year-old female. At the end of May, she noticed excessive menstrual bleeding and the development of numerous petechiae. She visited the outpatient clinic of our hospital on June 5. The peripheral blood showed many blasts, and a definite diagnosis of acute lymphocytic leukemia was made by examination of the bone marrow. Chemotherapy in accordance with the protocol of JALSG-ALL97 was started on June 11, and complete remission was achieved. During the course of chemotherapy, she had low-grade fever, and the chest X-ray film on July 3 showed an infiltrative shadow in the right lower lung field. Therefore, she received by turns several antibiotics and antifungal agents such as CZOP, MCFG, CFPM, MEPM and FCLZ, but the low-grade fever continued. On July 11, chest X-ray film and CT scan showed a cavitary lesion in the right lower lung field. Aspergillosis was suspected and ITCZ was administered from July 12. Although bronchoscopy was performed on July 22, a definite diagnosis could not be established. On July 31, right lower lobectomy was performed for the purpose of final diagnosis and treatment. The final pathological diagnosis was invasive mucormycosis. The postoperative course was good, and she received consolidation chemotherapy from August 20, continuing the administration of ITCZ.
