Influenza-Associated Disseminated Aspergillosis in a 9-Year-Old Girl Requiring ECMO Support
| Autor: | María Teresa Martín-Gómez, Jacques G. Rivière, Jaume Izquierdo-Blasco, Susana Melendo-Perez, Monica Velasco-Nuño, Natalia Mendoza-Palomar, Joan Balcells, Pere Soler-Palacín |
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| Přispěvatelé: | Institut Català de la Salut, [Mendoza-Palomar N, Melendo-Pérez S, Rivière JG, Soler-Palacin P] Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca en Infecció en el Pacient Pediàtric Immunodeprimit, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Balcells J] Unitat de Cures Intensives Pediàtriques, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca Clínica/Innovació en la Pneumònia i Sèpsia (CRIPS), Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Izquierdo-Blasco J] Unitat de Cures Intensives Pediàtriques, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Martín-Gómez MT] Servei de Microbiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca en Microbiologia, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Velasco-Nuño M] Servei de Medicina Nuclear, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Myocarditis QH301-705.5 Fulminant medicine.medical_treatment Case Report Medicaments antifúngics - Ús terapèutic Plant Science neuroaspergillosis enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares fúngicas::aspergilosis pulmonar [ENFERMEDADES] Aspergillus fumigatus Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores] children Intensive care Amphotericin B medicine Extracorporeal membrane oxygenation Biology (General) Respiratory Tract Diseases::Lung Diseases::Lung Diseases Fungal::Pulmonary Aspergillosis [DISEASES] Ecology Evolution Behavior and Systematics Grip - Complicacions acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antifúngicos [COMPUESTOS QUÍMICOS Y DROGAS] biology Aspergil·losi pulmonar - Tractament business.industry invasive pulmonary aspergillosis isavuconazole human influenza medicine.disease biology.organism_classification Surgery Pneumonia Respiratory Tract Diseases::Respiratory Tract Infections::Influenza Human [DISEASES] Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antifungal Agents [CHEMICALS AND DRUGS] enfermedades respiratorias::infecciones del tracto respiratorio::gripe humana [ENFERMEDADES] Decompressive craniectomy business Other subheadings::Other subheadings::/complications [Other subheadings] medicine.drug |
| Zdroj: | Journal of Fungi, Vol 7, Iss 726, p 726 (2021) Scientia Journal of Fungi |
| Popis: | Nens; Influenza humana; Isavuconazol Niños; Influenza humana; Isavuconazol Children; Human influenza; Isavuconazole A previously healthy 9-year-old girl developed fulminant myocarditis due to severe influenza A infection complicated with methicillin-resistant Staphylococcus aureus pneumonia, requiring extracorporeal membrane oxygenation (ECMO) support. Twelve days after admission, Aspergillus fumigatus was isolated in tracheal aspirate, and 12 h later she suddenly developed anisocoria. Computed tomography (CT) of the head showed fungal brain lesions. Urgent decompressive craniectomy with lesion drainage was performed; histopathology found hyphae in surgical samples, culture-positive for Aspergillus fumigatus (susceptible to azoles, echinocandins, and amphotericin B). Extension workup showed disseminated aspergillosis. After multiple surgeries and combined antifungal therapy (isavuconazole plus liposomal amphotericin B), her clinical course was favorable. Isavuconazole therapeutic drug monitoring was performed weekly. Extensive immunological study ruled out primary immunodeficiencies. Fluorine-18 fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) follow-up showed a gradual decrease in fungal lesions. Influenza-associated pulmonary aspergillosis is well-recognized in critically ill adult patients, but pediatric data are scant. Clinical features described in adults concur with those of our case. Isavuconazole, an off-label drug in children, was chosen because our patient had severe renal failure. To conclude, influenza-associated pulmonary aspergillosis is uncommon in children admitted to intensive care for severe influenza, but pediatricians should be highly aware of this condition to enable prompt diagnosis and treatment. This work received no external funding. |
| Databáze: | OpenAIRE |
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