Bowel Perforation Due to Disseminated Candidiasis at Initial Remission Induction in an Infant with Acute Myelomonocytic Leukemia

Abstract

A 1 year and 2 month-old girl with fever, swelling of the cheek and exophthalmos was diagnosed having AMMoL (FAB, M4). The cytogenetic study of the blast cells showed an abnormal karyotype of 45, XX, -10, -11, +der (11) t(10;11) (10p 15→10q ter:: 11p ter→11q23). With ACMA-BHAC therapy, the patient attained partial remission. However, agranulocytosis and unremitting high fever continued and skin lesions developed throughout the body. The patient died of bowel perforation 5 weeks later. Autopsy revealed numerous fungal nodules in multiple organs including the perforated lesions, and candida tropicalis was identified by the culture of spleen and pleural effusion.