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Volume 45, Number 2, April 2012

Fulminant Aeromonas hydrophila infection during acute lymphoblastic leukemia treatment


Vassilios Papadakis, Nikolaos Poniros, Karerina Katsibardi*, Athina-Eleni Charissiadou, John Anastasopoulos, Sophia Polychronopoulou


Received: March 11, 2010    Revised: May 11, 2010    Accepted: July 20, 2010   

 

Corresponding author:

Department of Pediatric Hematology-Oncology, “Aghia Sophia” Children’s Hospital, Thivon & Livadias
Ave, Goudi, Athens 11527 Greece.
E-mail address: katharinakats@hotmail.com (K. Katsibardi).



 

Background and purpose: 

Aeromonas hydrophila septicemia has a fulminant course and it has been usually reported in immunocompromised hosts and rarely among children with leukemia. High morbidity and mortality is associated with A hydrophila infections. We describe the case of a child with acute lymphoblastic leukemia who presented with septicemia due to A hydrophila. The patient presented with fever and skin discoloration during a febrile neutropenia episode, which rapidly evolved into bacteremia and extensive thigh suppuration, fasciitis, and myonecrosis. Apart from antibiotic treatment, surgical debridement to relieve compartment pressure and prevent further lower extremity compromise was promptly performed. Despite long delays in chemotherapy and an extensive tissue gap, primary closure of the involved area was possible with full
cosmetic and functional limb recovery, and the patient has remained in clinical remission for more than 7 years.



 

Key words:

Acute lymphoblastic leukemia; Aeromonas hydrophila; Fasciitis; Febrile neutropenia; Gangrene; Myonecrosis;
Septicemia