Concomitant Mycobacterium tuberculosis and Aspergillus niger infection in a patient with acute myeloid leukemia

• Published in: Chemotherapy (Basel) Vol. 49; no. 5; pp. 264 - 266
• Main Authors: AKSOY, Duygu Yazgan, TURKER, Alev, ALTUNDAG, M. Kadri, ABALI, Huseyin, DURUSU, Mine, ERMAN, Mustafa, UNER, Aysegul, SUNGUR, Ayse Arzu, UNAL, Serhat, UZUN, Omrum
• Format: Journal Article
• Language: English
• Published: Basel Karger 01.09.2003
• Subjects: Acute Disease; Antifungal Agents - therapeutic use; Antitubercular Agents - therapeutic use; Aspergillosis - drug therapy; Aspergillosis - etiology; Aspergillus niger; Bacterial diseases; Biological and medical sciences; Female; Human bacterial diseases; Human mycoses; Humans; Immunocompromised Host; Infectious diseases; Leukemia, Myeloid, Acute - complications; Medical sciences; Middle Aged; Mycobacterium tuberculosis; Mycoses; Mycoses of the skin; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Cutaneous - drug therapy; Tuberculosis, Cutaneous - etiology; Human; Mycosis; Malignant hemopathy; Fungi; Infection; Case study; Concomitant disease; Chemotherapy; Clinical management; Treatment; Mycobacterium tuberculosis; Mycobacteriales; Aspergillus niger; Aspergillosis; Mycobacteriaceae; Bacteria; Female; Actinomycetes; Fungi Imperfecti; Acute myeloid leukemia; Thallophyta; Acute myelocytic leukemia
• ISSN: 0009-3157; 1421-9794
• DOI: 10.1159/000072452

Primary cutaneous infection by Aspergillus spp. is an uncommon form of aspergillosis in patients with severe immunosuppression, e.g. patients with HIV infection or hematological malignancies. Disruption of the dermal integrity by trauma or maceration, followed by colonization of the wound by Aspergillus spp. creates a suitable environment for cutaneous infection. Despite aggressive therapy with amphotericin, primary cutaneous aspergillosis can lead to disseminated disease with fatal consequences. Tuberculosis is another rare infection in patients with hematological malignancies, but when present it is usually disseminated. We present a 46-year-old woman with acute myeloid leukemia who developed concomitantly Mycobacterium tuberculosis and Aspergillus niger infection. Cutaneous aspergillosis was diagnosed during neutropenia after induction therapy, which later became disseminated disease during antifungal therapy. Tuberculosis infection was diagnosed in a scalene lymph node biopsy specimen. The patient achieved remission of her underlying disease and responded very well to antituberculous and antifungal therapy.