A case of invasive aspergillosis in CGD patient successfully treated with Amphotericin B and INF-污

作者：Setareh Mamishi; Kamiar Zomorodian; Farshid Saadat; Mohsen Gerami Shoar; Bita Tarazooie; Seyad Ahmad Siadati

来源：Annals of Clinical Microbiology and Antimicrobials, 2005.

DOI：10.1186/1476-0711-4-4

Here, we describe Aspergillus osteomyelitis of the ribs and hepatic abscess in a 5-year-old boy. The patient was successfully treated with Amphotericin B and INF-污.With respect to the high frequency of aspergillosis in the CGD patient, immune deficiency should be investigated in patients with invasive aspergillosis. Moreover, using antifungal drugs as prophylaxis can improve the quality of life in these patients.Chronic granulomatous disease (CGD) is a rare inherited disorder of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex of phagocytic cells resulting in failure to generate reactive oxidants and the absence of a respiratory burst [1]. The disease is characterized by recurrent or persistent intra-cellular bacterial and fungal infections. Approximately, the incidence of fungal infections in CGD patients has been reported up to 20% of infections [2]. Aspergillus spp are ubiquitous saprophytic fungi and are considered as the major causative fungal agent in these patients [2,3]. The spectrum of infection caused by Aspergillus species varies from flu-like pneumonia to life-threatening invasive aspergillosis [4]. The most common form of the aspergillosis in CGD patients is Aspergillus pneumonia which can be accompanied by dissemination to the ribs, chest wall and soft tissues [1,2]. Here, we describe a case of invasive aspergillosis in CGD patient with hepatic abscesses and osteomyelitis.A 5-year-old male patient was admitted to Children Medical Center (CMC) with inflammation and swelling in his left mandible and wrist without a history of trauma. In the past, he had suffered from several episodes of pneumonia which started at the age of seven months. On admission, laboratory findings included erythrocyte sedimentation rate (ESR) 84 mm/h, WBC count 12100/mm3 (61% neutrophils, 39% lymphocytes), hemoglobin 11.3 gr/dl and thrombocyte 386000/mm3. As the CRP analysis displayed 20 mg/dl, cephalexin (150 mg/kg/day) was initiated. In his roentgenogram, oste