Clin Pediatr Hematol Oncol.  2014 Oct;21(2):172-176. 10.0000/cpho.2014.21.2.172.

A Case of Appendicitis with Liver Abscesses Developed during Allogeneic Hematopoietic Stem Cell Transplantation

• Lee SB
• Lee JM
• Lee SW
• Yoo ES
• Ryu KH

• KMID: 2279831
• DOI: http://doi.org/10.0000/cpho.2014.21.2.172

Abstract

A 10-year-old boy with severe aplastic anemia was admitted for allogeneic hematopoietic stem cell transplantation. After conditioning chemotherapy using cyclophosphamide, fludarabine, and antithymocyte immunoglobulin, he presented with fever and abdominal pain on day 0 of stem cell transplantation. After diagnosis of acute appendicitis with minor perforation, appendectomy was performed just after cell infusion. A week after the procedure, he showed two huge liver abscesses in S4 and S6 segments. We used broad spectrum antibiotics along with antifungal agents. Percutaneous drainage was attempted, but no fluid was removed and no microorganisms were isolated. After 7 weeks of antibiotics and antifungal therapy, liver abscesses showed improvement. We report a case of successfully treated appendicitis with liver abscesses in a severely neutropenic patient during allogeneic hematopoietic stem cell transplantation.

Keyword

Allogneic hematopoietic stem cell transplantation; Appendicitis; Neutropenic patients; Liver abscess; Typhlitis

MeSH Terms

Abdominal Pain
Anemia, Aplastic
Anti-Bacterial Agents
Antifungal Agents
Appendectomy
Appendicitis*
Child
Cyclophosphamide
Diagnosis
Drainage
Drug Therapy
Fever
Hematopoietic Stem Cell Transplantation*
Humans
Immunoglobulins
Liver Abscess*
Male
Stem Cell Transplantation
Typhlitis
Anti-Bacterial Agents
Antifungal Agents
Cyclophosphamide
Immunoglobulins