The spectrum of clinical syndromes associated with aspergillosis is diverse, ranging from allergic responses to the organism, colonization, superficial infection, acute or subacute invasive disease and asymptomatic. Generally, the clinical presentation reflects the underlying immune defects and risk factors associated with each patient group, with grater immunesuppression correlating with increased risk for invasive disease.Aspergillus fumigatus is the most pathogenic species and is the most common species in invasive infection.Patients with established invasive aspergillosis have a poor outcomes even with recent advances in therapy, and antifungal agents have been developed for this disease, including the newer antifungals, lipid formulation of amphotericin-B, and an additional drug class, the echinocandins. We report on three cases of aspergillosis in pediatric patients with risk factors associated to invasive disease. Case report 1: Masculine patient 8 months old, with pulmonary veins anomaly connection as diagnosis. The patient was transferred to the intensive care unit because of respiratory decompensation. The patient was intubated for artificial respiration. Disorder respiratory pneumonia and was obtained to become A. fumigatus by bronchoalveolar lavage culture. Were applied fluconazole, amphotericin-B and voriconazole as treatment. Next, was developed and, pulmonary hemorrhage bronchospasms. The patient was not survive. Case report 2: 15-Year-old male patient who presents difficulty breathing, hypotension, pericardial effusion with diagnosis of thoracic Lymphangioma and malnutrition. Thoracotomy is performed and joined the unit of intensive care with artificial respiration. Obtain crops with persistent growth of A. fumigatus from bronchial secretions. Starts treatment with amphotericin b and fluconazole Develops pulmonary hemorrhage. The patient did not survive. Case report 3: Female patient from 4 months of age with a diagnosis of anomalous connection of Pulmonary veins and malnutrition; who entered the intensive care unit presenting respiratory deterioration so it requires artificial respiration. The patient evolves with pulmonary hemorrhage and get crops of bronchial secretions with persistent growth of A. fumigatus. Starts treatment with amphotericin- B, caspofungina, currently continues with pulmonary hemorrhage and antifungal treatment from 3 weeks ago.
Full conference title:
18th International Society for Human and Animal Mycology
- ISHAM 18th (2012)