Invasive pulmonary aspergillosis in a neonate treated successfully with amphotericin B and itraconazole. A case report

Abstract

A rare case of invasive pulmonary asp ergillosis in a one- month-old neonate caused by Aspergillus flavus is reported. The diagnosis was based upon repeated demonstration of hyaline, septate branched hyphae in KOH wet mounts of bronchoalveolar lavage, histopathologic examination of a tissue mass protruding into the right main bronchus and repeated isolations of Aspergillus flavus in culture. The main predisposing factors were combined variable immunodeficiency/transient hypoglobulinemia of infancy and repeated administration of broad spectrum antibiotics used to treat recurrent episodes of bacterial infections. The neonate was treated successfully with combined therapy of intravenous amphotericin B deoxycholate and oral itraconazole aided by partial removal of the infected tissue mass protruding in the right main bronchus by wire basket and by bronchoscopic suction. He had no relapse during a follow up of about 1 year. As far as we are aware, this is the first case of invasive pulmonary aspergillosis in a neonate with combined variable immunodeficiency/transient hypoglobulinemia of infancy who also survived the infection due to timely diagnosis and therapy with amphotericin B and itraconazole.