Isolated fungal liver abscess in pediatric acute lymphoblastic leukemia – A case report

Diagnosis and management of invasive fungal infections pose a challenge to the treating physician in patients with hematological malignancies. The incidence is lesser in acute lymphoblastic leukemia (ALL), compared to the other hematological malignancies. The diagnosis is often delayed due to the non-specific clinical findings and negative cultures. Here, we report a case of B-cell ALL, on chemotherapy, diagnosed to have hepatic fungal abscess caused by Aspergillus fumigatus species. Interestingly, the patient did not have neither neutropenia nor any other systemic involvement of fungal infection at presentation. The case was successfully managed with percutaneous drainage and systemic antifungal therapy using voriconazole. Timely intervention helped in the diagnosis and proper management of the case, thus preventing a disseminated invasive fungal infection.