A 4-year-old child with leukemia and an enlarging arm lesion

A 4-year-old boy was admitted to hospital with a diagnosis of pre-B-cell acute lymphoblastic leukemia. Ten days later, he experienced fever, neutropenia and a lesion on the lateral aspect of his left arm just above the elbow. The purplish lesion was 1 cm in diameter and was not painful. The child wa...

Full description

Saved in:
Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2005-02, Vol.172 (3), p.332-332
Main Authors: Mater, Ahmed, Al-Sulaiti, Ghada, Johnston, Donna L, Slinger, Robert
Format: Article
Language:English
Subjects:
Arm
Bandages - adverse effects
Care and treatment
Child, Preschool
Humans
Injuries
Leukemia in children
Male
Mucormycosis - diagnosis
Mucormycosis - etiology
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - complications
Rhizopus - isolation & purification
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 4-year-old boy was admitted to hospital with a diagnosis of pre-B-cell acute lymphoblastic leukemia. Ten days later, he experienced fever, neutropenia and a lesion on the lateral aspect of his left arm just above the elbow. The purplish lesion was 1 cm in diameter and was not painful. The child was given piperacillin and gentamicin, but the lesion increased in size and became necrotic. Ecthyma gangrenosum due to disseminated bacterial infection was initially suspected. However, a skin biopsy revealed wide, aseptate fungal hyphae, consistent with an agent of mucormycosis. The infected site had been under adhesive tape that was used to secure an intravenous catheter, removed several days before, in the antecubital fossa. CT examinations showed that the patient's chest and sinuses were normal, and the child was clinically well. Primary cutaneous mucormycosis was felt to be the probable diagnosis. Therapy with amphotericin B was started and then changed to 5 mg/kg of amphotericin B lipid complex per day because of renal impairment. The lesion, which had continued to enlarge, was fully excised.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.1041231