Cryptococcal meningitis following a thrombotic microangiopathy in an unrelated donor bone marrow transplant recipient
| Autor: | Roberto Miniero, E. Vassallo, Sergio Vai, F Nesi, G De Intinis, Alessandro Busca, Mareva Giacchino, R Targhetta, F Papalia |
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| Rok vydání: | 1997 |
| Předmět: |
Pathology
medicine.medical_specialty Thrombotic microangiopathy Cyclophosphamide Meningitis Cryptococcal Fatal Outcome Cyclosporin a Medicine Humans Transplantation Homologous Child Bone Marrow Transplantation business.industry Histocompatibility Testing Microcirculation Thrombosis Hematology Total body irradiation medicine.disease Tissue Donors Transplantation medicine.anatomical_structure Oncology Pediatrics Perinatology and Child Health Cryptococcosis Female Bone marrow business Meningitis medicine.drug |
| Zdroj: | Pediatric hematology and oncology. 14(5) |
| ISSN: | 0888-0018 |
| Popis: | In patients undergoing bone marrow transplantation cryptococcosis is rarely encountered. We report a fatal case of Cryptococcus meningitis in a 12-year-old girl with acute lymphoblastic leukemia (ALL) in second remission who had a transplant from a human leukocyte antigen (HLA)-identical unrelated bone marrow donor. The conditioning regimen was thiotepa, cyclophosphamide, and total body irradiation (TBI); graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A, methotrexate, and antilymphocyte globulin (ALG). The patient experienced stage III GVHD responsive to high-dose corticosteroids. On day +54 a thrombotic microangiopathy occurred. On day +64 neurological status worsened; a brain computed tomographic (CT) scan showed hyperdense lesions suggesting fungal infection. Detection of cryptococcal antigen by latex agglutination was positive but India ink stain and culture were negative. Despite treatment with amphotericin B, 5-flucytosine, and granulocyte-macrophage colony-stimulating factor, the patient died 13 days after the diagnosis. |
| Databáze: | OpenAIRE |
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