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Case Report of a Child after Hematopoietic Cell Transplantation with Acute Aspergillus Tracheobronchitis as a Cause for Respiratory Failure

View Article: PubMed Central - PubMed

ABSTRACT

Rapid respiratory failure due to invasive mycosis of the airways is an uncommon presentation of Aspergillus infection, even in immunocompromised patients, and very few pediatric cases have been reported. Patients with Aspergillus tracheobronchitis present with nonspecific symptoms, and radiologic studies are often noninformative, leading to a delay in diagnosis. Prompt initiation of adequate antifungal therapies is of utmost importance to improve outcome. We report the case of a 9-year-old girl with chronic myelogenous leukemia who developed respiratory distress 41 days after hematopoietic cell transplantation and rapidly deteriorated despite multiple interventions and treatment modalities.

No MeSH data available.


Related in: MedlinePlus

Grocott's methenamine silver stain of a piece of pseudomembrane obtained during bronchoalveolar lavage showed dichotomously branched and septate hyphae, suggestive of the diagnosis of Aspergillus. 400-fold magnification.
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fig3: Grocott's methenamine silver stain of a piece of pseudomembrane obtained during bronchoalveolar lavage showed dichotomously branched and septate hyphae, suggestive of the diagnosis of Aspergillus. 400-fold magnification.

Mentions: Microscopic examination of the debris obtained by bronchoalveolar lavage confirmed fungal elements consistent with Aspergillus fumigatus (Figure 3). Sputum and airway tissue cultures eventually grew Aspergillus fumigatus 5 days postmortem as well. Systemic antifungal therapy was broadened to include nebulized amphotericin B (2.5 mg/hour) and enteral posaconazole (200 mg PG q6h 5-6 mg/kg 4 times daily).


Case Report of a Child after Hematopoietic Cell Transplantation with Acute Aspergillus Tracheobronchitis as a Cause for Respiratory Failure
Grocott's methenamine silver stain of a piece of pseudomembrane obtained during bronchoalveolar lavage showed dichotomously branched and septate hyphae, suggestive of the diagnosis of Aspergillus. 400-fold magnification.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5120194&req=5

fig3: Grocott's methenamine silver stain of a piece of pseudomembrane obtained during bronchoalveolar lavage showed dichotomously branched and septate hyphae, suggestive of the diagnosis of Aspergillus. 400-fold magnification.
Mentions: Microscopic examination of the debris obtained by bronchoalveolar lavage confirmed fungal elements consistent with Aspergillus fumigatus (Figure 3). Sputum and airway tissue cultures eventually grew Aspergillus fumigatus 5 days postmortem as well. Systemic antifungal therapy was broadened to include nebulized amphotericin B (2.5 mg/hour) and enteral posaconazole (200 mg PG q6h 5-6 mg/kg 4 times daily).

View Article: PubMed Central - PubMed

ABSTRACT

Rapid respiratory failure due to invasive mycosis of the airways is an uncommon presentation of Aspergillus infection, even in immunocompromised patients, and very few pediatric cases have been reported. Patients with Aspergillus tracheobronchitis present with nonspecific symptoms, and radiologic studies are often noninformative, leading to a delay in diagnosis. Prompt initiation of adequate antifungal therapies is of utmost importance to improve outcome. We report the case of a 9-year-old girl with chronic myelogenous leukemia who developed respiratory distress 41 days after hematopoietic cell transplantation and rapidly deteriorated despite multiple interventions and treatment modalities.

No MeSH data available.


Related in: MedlinePlus