Hard palate perforation due to invasive aspergillosis in a patient with acute lymphoblastic leukemia

• Published in: International journal of pediatric otorhinolaryngology Vol. 69; no. 10; pp. 1395 - 1398
• Main Authors: Karabulut, Aylin Bilgin, Kabakas, Fatih, Berköz, Ömer, Karakas, Zeynep, Kesim, Sinan Nur
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-10-2005
• Subjects: Aspergillosis - complications; Aspergillosis - drug therapy; Child, Preschool; Female; Humans; Jaw Diseases - etiology; Jaw Diseases - therapy; Oral Fistula - etiology; Oral Fistula - therapy; Oral invasive aspergillosis; Oral Surgical Procedures - methods; Palatal fistula; Palate, Hard - pathology; Palate, Hard - surgery; Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Oral invasive aspergillosis; Palatal fistula
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2005.03.035

Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunosuppressed patients. Primary oral invasive aspergillosis is a rare condition. We present an acute lymphoblastic leukemia (ALL) patient with hard palate perforation due to invasive aspergillosis. Two months after the appearance of the fungal lesions, perforation of the hard palate was seen despite amphotericin-b and itracanazole therapy. After debridement of necrotic tissue the patient was followed for spontaneous closure for 6 months but it was seen that the fistula persisted despite the disappearance of the infection. The patient was operated for closure of the palatal fistula and there was no recurrence in 6 months of follow up. Surgical and medical management was performed successfully. Invasive oral aspergillosis is a potentially lethal disease and it should be considered in immunosuppressed patients with oral lesions.