Pulmonary Tuberculosis in a Child Receiving Intensive Chemotherapy for Acute Myeloblastic Leukemia

Abstract

The authors describe a 6-year-old boy who developed pulmonary tuberculosis during intensive chemotherapy for acute myeloblastic leukemia (AML). The diagnosis of tuberculosis was made by PCR from an open lung biopsy, while a bacterial culture was negative. The patient was treated with triple tuberculostatic drug therapy, followed by two-drug therapy, while receiving maintenance chemotherapy for AML, including thioguanine and cytarabine. Pulmonary infiltrates resolved within 2 months of treatment. However, possibly due to the bone marrow toxicity of the tuberculostatic drugs, the patient tolerated only low doses of cytostatic therapy. The boy is now 14 months off tuberculostatic treatment and 8 months off AML therapy. He is in remission of AML and tuberculosis.

Differential diagnosis between AML infiltration, lymphoma and tuberculosis in a patient presenting with fever and mediastinal lymphadenopathy: A case report

“…Long-lasting hematogenous, lymphogenous, endobronchial and local spread of the disease results in variable radiological appearances (6). Previously, Al-Anazi et al considered that the radiographic appearances of tuberculosis, in descending order, were as follows: Areas of pulmonary consolidation consistent with pneumonia; nodular shadows consistent with pulmonary fibrosis; calcification, pleural effusions or lymph node enlargement; and cavity formation or miliary shadows (7).…”

“…However, a number of patients had no sputum or complained only of a dry cough when without extensive infiltration of the lung or pleural effusion, or developed extrapulmonary tuberculosis only. In addition, immunosuppressed patients are less likely to exhibit positive sputum staining for AFB (6,11). In the current case report, the patient had a prolonged dry cough and even when the patient coughed white frothy sputum, the sputum staining for AFB and sputum cultures for fungi and bacteria were all negative.…”

“…Immunosuppressed patients are less likely to develop a positive tuberculin skin test (6). However, the current patient exhibited a marked response to the PPD skin test and PPD IgG Ab in the blood was also positive, which aided the diagnosis of tuberculosis.…”

Simultaneous Diagnosis of Myeloid Sarcoma of the Jaw and <i>Mycobacterium tuberculosis</i> Infection

“…Tuberculosis diagnosis was performed during nadir and medical attention was given to assess and treat any other additional infectious disease which did not occur. To date the course of disseminated tuberculosis is usually fatal in immunocompromised patients and the current present case patient presented successful bone marrow recovery, achieved complete remission and did not present any further infectious disease complications throughout AML chemotherapy treatment [2][3][4][5][6][7][8][9].…”

“…Conversely, the diagnosis of a simultaneous occurrence of a rare hematological neoplasm such as MS and bone tuberculosis at initial presentation and from the same involved site seemed quite unusual and due to its rarity and interest, we aimed to report this case [3][4][5][6][7][8][9] Imaging studies revealed lytic jaw lesions not other bone was involved (CT scans). Abdominal and thorax CT scans were unremarkable.…”