Catch-22 Situation with Unexpected Reports in Acute Lymphoblastic Leukemia

Abstract Central nervous system (CNS) infections are relatively common among children receiving treatment for acute lymphoblastic leukemia (ALL). However, diagnosing these infections presents challenges. In this report, we present a case of asymptomatic adenoviral meningitis, which presented a diagnostic challenge as it mimicked CNS involvement in a child undergoing treatment for ALL. Our findings underscore the importance of thorough diagnostic evaluation for CNS infections in children undergoing ALL therapy, whether they present with symptoms or exhibit asymptomatic cerebrospinal fluid pleocytosis. Furthermore, distinguishing between infections and CNS leukemia is critical, highlighting the necessity of employing flow cytometry to mitigate the potential misinterpretation of morphological features.