Aspergillosis
-
Aspergillosis is manifested by noninvasive and invasive disease of several
types.
- Allergic
bronchopulmonary aspergillosis (ABPA)
occurs most frequently in immunocompetent children who have
chronic asthma or cystic fibrosis
and manifests as:
- episodic
wheezing
-
expectoration of brown mucus plugs
- low-grade
fever
-
eosinophilia
- transient
pulmonary infiltrates.
-
Invasive aspergillosis occurs
almost exclusively in immunocompromised patients who have
-
neutropenia
- neutrophil dysfunction,
primary
or due to
underlying disease (eg, chronic
granulomatous disease) or medication use (eg,
corticosteroids)
- after
cytotoxic chemotherapy or immunosuppressive therapy (eg, organ
transplantation)
- Invasive
infection usually involves pulmonary,
sinus, cerebral, or cutaneous sites
- the
hallmark is angioinvasion,
with resulting thrombosis,
dissemination to other
organs, and occasionally, erosion of the blood vessel wall and catastrophic
hemorrhage
- Rarely,
-
endocarditis
-
osteomyelitis
-
meningitis
-
infection of the eye or orbit
-
esophagitis
American
Academy of Pediatrics. Aspergillosis. In: Pickering LK, ed.
2000 Red Book: Report of the Committee on Infectious Diseases. 25th
ed. Elk Grove Village, Ill: American Academy of Pediatrics;
2000:178-179