Rare cause of sepsis in an immunocompromised child with acute lymphocytic leukaemia - A Case Report

Haematological malignancies are at a high risk of fungal infection and subsequent high mortality. A patient with a relapsed acute lymphocytic leukaemia (ALL) and a rare fungal infection is presented.

A four-year-old patient with ALL relapsed after 3 years of remission. He presented with a papular, erythematous rash mainly on the limbs and trunk, accompanied with high intermittent fever which did not respond to broad spectrum antibiotics.

Histopathological examination of a skin biopsy revealed yeast cells. Trichosporon species was isolated on culture. Voriconazole was started according to sensitivity test results and a brief response was demonstrated. Clinical deterioration was seen with worsening of the underlying malignancy. Amphotericin B was added with poor response. Unfortunately, he succumbed to his disease process without recovery from fever, skin rash or the malignancy.

Trichosporon species is a rare infection even in patients with haematological malignancies. Recovery from neutropenia is an important prognostic factor in the treatment of trichosporonosis.