Abstract
We report a case of an 8-year-old boy with relapsed acute lymphocytic leukemia who was complicated with adult respiratory distress syndrome (ARDS) due to Streptococcus mitis after bone marrow transplantation (BMT). Although he underwent allogeneic BMT during his third complete remission in November 1991, bone marrow relapse developed in April 1992. During the fourth reinduction therapy, severe dyspnea and hypotension developed and S. mitis was identified by a venous blood culture. A chest X-ray confirmed the diagnosis of ARDS. Cultured S. mitis was susceptible to the antibiotics administered at that time, and the ARDS was successfully treated by mechanical ventilation with PEEP of 8 cmH2O and steroid pulse therapy. However, the patient died of multiple organ failure with a systemic fungal infection two weeks after recovery from ARDS. Septicemia and ARDS due to α-Streptococci are increasing among pediatric patients with malignant diseases. This case indicates the importance of the awareness of septicemia and ARDS due to α-Streptococci during intensive chemotherapy against malignant pediatric diseases.
