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Case Records of the Massachusetts General Hospital
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Volume 350:1339-1347 March 25, 2004 Number 13
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Case 10-2004 — A 58-Year-Old Man with Acute Myeloid Leukemia and Fever after Chemotherapy
Jay A. Fishman, M.D., Bimalangshu R. Dey, M.D., and Robert P. Hasserjian, M.D.

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Presentation of Case

Dr. Bimalangshu R. Dey: A 58-year-old man with a large sacral ulcer was admitted to the hospital for chemotherapy to treat acute myeloid leukemia.

The patient had had recurrent infections of a pilonidal cyst for 20 years; the infections had required surgical débridement on multiple occasions. Six weeks before admission to this hospital, he was admitted to another hospital with a temperature as high as 39.4°C with chills and rigors. The pilonidal cyst had a malodorous, purulent discharge and was surrounded by fluctuant, swollen tissue. Surgical incision and drainage were performed. The white-cell count was 7500 per cubic millimeter, with . . . [Full Text of this Article]

Pathological Discussion

Pathological Diagnosis

Presentation of Case (Continued)

Differential Diagnosis

Discussion of Management

Guidelines for Treating Infections in Immunocompromised Patients

General Principles

Risk of Infection

Care of This Patient


Source Information

From the Transplant Infectious Disease and Compromised Host Program, Infectious Disease Division (J.A.F.), the Bone Marrow Transplant Unit, Hematology Oncology Division (B.R.D.), and the Department of Pathology (R.P.H.), Massachusetts General Hospital; and the Departments of Medicine (J.A.F., B.R.D.), and Pathology (R.P.H.), Harvard Medical School.



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