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

Author:

Gauguet Stefanie1ORCID,Madden Kate2,Wu Jennifer3,Duncan Christine3,Lee Gi Soo4,Miller Tonya2,Klingensmith William C.5,Burchett Sandra K.6,van der Velden Meredith2

Affiliation:

1. Division of Pediatric Critical Care, Department of Pediatrics, UMass Memorial Children’s Medical Center, University of Massachusetts Medical School, 55 North Lake Avenue, Worcester, MA 01655, USA

2. Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA

3. Division of Hematology/Oncology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA

4. Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA

5. Department of Pathology, Midland Memorial Hospital, Midland, TX 79701, USA

6. Division of Infectious Diseases, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA

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.

Publisher

Hindawi Limited

Subject

General Medicine

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