Acute respiratory distress syndrome due to tuberculosis in a child after allogeneic bone marrow transplantation for acute lymphoblastic leukemia
Journal
Journal of the Formosan Medical Association
Journal Volume
98
Journal Issue
10
Pages
701-704
Date Issued
1999
Author(s)
Abstract
We report the occurrence of tuberculosis in a 10-year-old Taiwanese boy, approximately 4 months after he received a matched-related bone marrow transplantation from his sister for acute T-cell lymphoblastic leukemia. After transplantation, grade III acute graft-versus-host disease developed and the patient was treated with prednisolone and cyclosporine. Marrow failure was noted on day 77 post-transplantation, however, after an episode of herpes zoster infection. Interstitial pneumonia, diagnosed on the basis of chest x-ray and computed tomography findings, occurred on day 120. Histologic examination of an open-lung biopsy specimen showed caseating granulomas and a few acid-fast bacilli. The patient died of acute respiratory distress syndrome, despite immediate implementation of anti-tuberculosis therapy. Sputum cultures grew Mycobacterium tuberculosis 5 weeks later. This report demonstrates that the possibility of tuberculosis needs to be considered in immunocompromised patients, and that appropriate prophylaxis should be instituted in areas where tuberculosis is endemic.
SDGs
Other Subjects
aciclovir; cyclosporin; isoniazid; methylprednisolone; prednisolone; pyrazinamide; rifampicin; tuberculostatic agent; acute lymphoblastic leukemia; allogenic bone marrow transplantation; article; case report; child; computer assisted tomography; graft versus host reaction; herpes zoster; human; interstitial pneumonia; male; mycobacterium tuberculosis; open lung biopsy; respiratory distress syndrome; sputum culture; thorax radiography; tuberculosis; Bone Marrow Transplantation; Child; Humans; Leukemia, Lymphocytic, Acute, L1; Male; Respiratory Distress Syndrome, Adult; Tuberculosis, Pulmonary
Type
journal article