Subclavian mycotic aneurysm caused by Aspergillus flavus in a child with acute lymphoblastic leukemia: a case report


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İnceli B. H., ÖZDEMİR H., İNCE E., ARGA G., Penezoğlu D. N., ÇAKMAKLI H. F., ...More

Frontiers in Pediatrics, vol.13, 2026 (SCI-Expanded, Scopus) identifier identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 13
  • Publication Date: 2026
  • Doi Number: 10.3389/fped.2025.1736632
  • Journal Name: Frontiers in Pediatrics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
  • Keywords: acute lymphoblastic leukemia, Aspergillus flavus, child, invasive aspergillosis, mycotic aneurysm
  • Ankara University Affiliated: Yes

Abstract

Invasive aspergillosis is a severe opportunistic infection in immunocompromised children, particularly those receiving chemotherapy for hematologic malignancies. We report the case of a 2-year-old girl with acute lymphoblastic leukemia who developed massive hemoptysis during consolidation chemotherapy. Thoracic computed tomography revealed a saccular pseudoaneurysm of the proximal left subclavian artery. Surgical resection and autologous vein graft replacement were performed, and Aspergillus flavus DNA was detected in the resected tissue using Aspergillus-specific polymerase chain reaction. The patient received dual antifungal therapy with liposomal amphotericin B and voriconazole, followed by long-term voriconazole prophylaxis. She made a full recovery. This case highlights the importance of considering angioinvasive aspergillosis in immunocompromised children presenting with hemoptysis and lung lesions. Early recognition and multidisciplinary management are critical to preventing fatal vascular complications.