Spontaneous Pneumothorax in Patients with Leukemia: First Sign of Invasive Mycosis?

  1. Corrado Girmenia, MD;
  2. Vittorio Donato, MD;
  3. Anna Paola Iori, MD; and
  4. Pietro Martino, MD
  1. From Universita degli Studi La Sapienza, Rome, Italy. Requests for Reprints: Pietro Martino, MD, Istituto di Ematologia, Via Benevento 6, 00161 Rome, Italy. Grant Support: In part by grant 92.0221.939 from Progetto Finalizzato Applicazioni Cliniche alla Ricerca Oncologica, Centro Nazionale delle Ricerche, Italy.

    Abstract

    Two patients with leukemia, who underwent remission induction chemotherapy and allogeneic bone marrow transplantation, respectively, reported chest pain and dyspnea after recovery from neutropenia. In both patients, chest radiographs showed only a pneumothorax, whereas computed tomographic scanning also showed a peripheral pseudomycetoma. Antifungal treatment was instituted. The occurrence of spontaneous pneumothorax in patients with hematologic malignancies, particularly after recovery from neutropenia, may indicate the presence of a subpleural infection. Computed tomographic scanning can reveal peripheral pulmonary lesions that are not detected by chest roentgenography.

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    1. Ann Intern Med May 1, 1993 vol. 118 no. 9 707-708
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