A 21 -year-old woman with acute lymphocytic leukemia developed clinical and radiographic signs of epiglottitis. Premortem and postmortem histologic studies showed invasive aspergillosis; Aspergillus flaws was grown in culture. The necrotizing nature of this infection is explained by the predilection of Aspergillus sp. for invasion of blood vessels. The usual causative agents of epiglottitis are bacteria; the association with fungal infection has not been previously described.
Cancer 51:367-370, 1983.
SPERGILLOSIS is a common infection in compro-
A mised hosts,'-3 and it appears to be increasing in freq~ency.~ This infection most commonly involves the respiratory tract. Involvement of the lungs, nose and paranasal sinuses occurs frequently. However, invasive aspergillosis of the epiglottis is surprisingly uncommon.
We recently saw a woman with necrotizing epiglottitis caused by aspergillus. Bacterial agents such as Haemophilus influenza type B, staphylococci, pneumococci, and occasionally streptococci6 are the usual cause of acute infectious epiglottitis. To our knowledge fungal infections, such as aspergillosis, have not been previously associated with this entity.
Case Report
A 2 1 -year-old previously healthy woman displayed weakness and developed symptoms of an upper respiratory infection. Acute leukemia was diagnosed after evaluation by her physician. The patient was admitted to The University of Texas M. D. Anderson Hospital and Tumor Institute where a diagnosis of acute lymphocytic leukemia with central nervous system involvement was established.
Physical examination on admission revealed a pale, moderately obese young woman. Except for a temperature of 38.3"C and a pulse of 98 the findings were normal. Laboratory data showed a hemoglobin of 8.5 g/lOO ml, a hematocrit of 27% and a leukocyte count of 6,600/mm3 with 63% blasts and 19% polymorphonucleocytes, I7 lymphocytes, and 1% bands. Platelets were 166,000/mm3. The chemistry profile was normal From the Departments of