Abstract
Abstract
Background
Pulmonary aspergillosis is a prevalent opportunistic fungal infection that can lead to mortality in pediatric patients with underlying immunosuppression. Appropriate and timely treatment of pulmonary aspergillosis can play a crucial role in reducing mortality among children admitted with suspected infections.
Case presentation
The present study reports three cases of inappropriate treatment of pulmonary aspergillosis caused by Aspergillus flavus in two Iranian pediatric patients under investigation and one Afghan patient. Unfortunately, two of them died. The cases involved patients aged 9, 1.5, and 3 years. They had been diagnosed with pulmonary disorders, presenting nonspecific clinical signs and radiographic images suggestive of pneumonia. The identification of A. flavus was confirmed through DNA sequencing of the calmodulin (CaM) region.
Conclusion
A. flavus was the most prevalent cause of pulmonary aspergillosis in pediatric patients. Early diagnosis and accurate antifungal treatment of pulmonary aspergillosis could be crucial in reducing the mortality rate and also have significant potential for preventing other complications among children. Moreover, antifungal prophylaxis seems to be essential for enhancing survival in these patients.
Funder
Mashhad University of Medical Sciences,
Publisher
Springer Science and Business Media LLC
Reference19 articles.
1. Shah K, Kumar A, Kumar A, Kumar N, Kaushik P, Thumallapalli A, et al. Pulmonary aspergillosis silently presenting as pneumothorax in children with leukemia: a report of three cases. Indian J Med Paediatr Oncol. 2022;43(05):439–42.
2. Zanganeh E, Zarrinfar H, Rezaeetalab F, Fata A, Tohidi M, Najafzadeh MJ, et al. Predominance of non-fumigatus Aspergillus species among patients suspected to pulmonary aspergillosis in a tropical and subtropical region of the Middle East. Microb Pathog. 2018;116:296–300.
3. Nourizadeh N, Adabizadeh A, Zarrinfar H, Majidi M, Jafarian AH, Najafzadeh MJ. Fungal biofilms in sinonasal polyposis: the role of fungal agents is notable? J Oral Maxillofac Surg Med Pathol. 2019;31(4):295–8.
4. Dehghani R, Mohammadi S, Zarrinfar H, Jarahi L, Najafzadeh MJ, Salah H. The emergence of decreased activity of amphotericin B and voriconazole against clinical isolates of Aspergillus species: a subtropical region of the Middle East. J Popul Ther Clin Pharmacol. 2023;30(17):146–54.
5. Ullmann AJ, Aguado JM, Arikan-Akdagli S, Denning DW, Groll AH, Lagrou K, et al. Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline. Clin Microbiol Infect. 2018;24:e1–38.