Pneumothorax and Acute Kidney Injury in the Early Phase of Acute Lymphoblastic Leukemia Induction Therapy due to Aspergillus Fumigatus and Pneumocystis Jirovecii Co-Infection: A Case Report

Leukemia is the most common malignancy in children which leads to immunosuppression and predisposes patients to opportunistic infections. We report a 12-year-old girl with acute lymphoblastic leukemia (ALL) who developed simultaneous infection with pneumocystis Jirovecii pneumonia and aspergillosis in the induction phase of chemotherapy. The patient developed pulmonary cavitation and pneumothorax which was treated with trimethoprim-sulfamethoxasole in addition to intravenous liposomal Amphotrecin B. Pediatric oncologists should consider concurrent co-infection of opportunistic infections such as aspergillus fumigatus and Pneumocystis Jirovecii in immunocompromised patients especially if pneumothorax develops in early stages of disease or immunosuppressive therapy.