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Pathological Case of the Month
David M. Fleece, MD;
Eric N. Faerber, MD;
Jean-Pierre de Chadarévian, MD, MD
From the Departments of Pediatrics (Dr Fleece), Radiology (Dr Faerber) and Pathology (Dr de Chadarévian), St Christopher's Hospital for Children; Temple University School of Medicine (Dr Fleece); and Allegheny University of the Health Sciences, MCP Hahnemann School of Medicine (Drs Faerber and de Chadarévian), Philadelphia, Pa.
Arch Pediatr Adolesc Med. 1998;152:1033-1034.
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A 5-YEAR-OLD boy with acute lymphoblastic leukemia presented with a 2-day history of fever and chills. The child had been treated with vincristine and L-asparaginase. He was receiving trimethoprim-sulfamethoxazole for Pneumocystis carinii prophylaxis, which was his only medication. Physical examination results were normal except for a mild left upper quadrant tenderness, but no organomegaly or masses.
Laboratory data included a hemoglobin level of 107 g/L, platelet count of 376x109/L, and white blood cell count of 10.3x109/L, with a normal differential cell count. Serum electrolytes, serum urea nitrogen, creatinine, serum transaminase, and amylase levels were all within normal limits. The chest radiograph revealed diffuse mild interstitial disease. Abdominal ultrasonography showed multiple small hypoechogenic foci within a normal-sized spleen and a normal-appearing liver, kidney, and pancreas. Abdominal computed tomography showed multiple small low-attenuation . . . [Full Text of this Article]
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