Combined pulmonary aspergillosis and tuberculosis in two children with acute leukaemia

The organisms that cause septicaemia or bacteraemia in immunocompromised patients are commonly found in their endogenous flora. However, multiple episodes of bacteraemia or polymicrobial tissue invasion are more likely to be hospital-acquired. The two cases presented here had concomitant polymicrobial tissue invasion followed by sepsis. The first case had infection with Aspergillus, Klebsiella and tuberculosis, while the second case was infected by Aspergillus and tuberculosis having a fatal outcome. Patients with polymicrobial bacteraemia have usually more severe clinical outcome and develop septic shock more readily than patients with monomicrobial infection. Oncologists need to target their antibiotic empirical therapy for hospital acquired infections according to the antibiogram of the hospital isolates. In unresolved pneumonia following broad-spectrum antibiotics administration, there is need for vigilance to identify unusual pathogens and opportunistic infections. Bizarre pathology such as turbeculosis and aspergillosis in children population should be considered and early invasive procedures for tissue diagnosis is warranted. Copyright © Hellenic Society of Haematology.