TREATMENT OF DEEP MYCOTIC INFECTION IN ADULT ACUTE LEUKEMIA

Abstract

Deep mycotic infection (DMI) is now being recognized in adult acute leukemia (AAL) patients with increased frequency. Fever, which is resistant to antibiotics and continue despite subsequent attainment of hematological remission, in one of the characteristic feature of DMI in AAL patients. The aspergillosis of lung and candidiasis of liver are most common. fungal infection in AAL patients. The trans-bronchial lung biopsy (TBLB) is the most useful technique for the diagnosis of lung aspergillosis. The AAL patients with lung aspergillosis must be received high dose amphotericin B (Amp-B) intravenously. Additionally, trans-bronchial administration of Amp-B is one of effective therapy in patients with lung cavity. The liver abscess in successfully diagnosed by ultrasonography or CT scan. Even if percutaneous liver aspiration or surgical excision are performed, the decision of pathogenic agents is very difficult. The administration of Amp-B must be tried through a catheter inserted into the portal vein at laparotomy in these patients.