Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | Search | About Us | FAQ | Reviews | Contact Us
Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Virtual Pediatric Hospital: Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease: Case 26 Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease

Case 26

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Chief Complaint:
Seven year old immune suppressed female with a fever.

Clinical History:
The patient was a 7 year old female who was status post allogeneic bone marrow transplant for congenital amegakaryocytic thrombocytopenia. Towards the end of her recovery from the bone marrow transplant she developed a fever.

Clinical Physical Exam:
Febrile.

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Aspergillosis, Pneumocystis carinii pneumonia

Imaging Findings:
AP chest film showed a cavitary lesion in the right lower lobe. Unenhanced and enhanced chest CT exam from the same day confirmed a cavitary lesion in the right lower lobe that appeared to also have an extrapleural component in the right paraspinal soft tissues.

icon gifImage 1

icon gifImage 2

icon gificon gifImages 3 and 4

Imaging Differential Diagnosis:
Aspergillosis

Operative Findings:
Immediately after the chest CT exam the patient underwent bronchoscopy. Cultures from that procedure grew out Aspergillus. She was placed on Amphotericin, but the lesion progressed. Seven days after the bronchoscopy the patient went to the operating room for a right lower lobe lobectomy and wedge biopsy of the right middle lung. The lesion was partially in the right lower lobe and was partially extrapleural.

Pathological Findings:
Pathological examination of the surgical specimen revealed the presence of aspergillosis

Final Diagnosis:
Aspergillosis

Follow-up and Prognosis:
The patient had a stormy postoperative course which resulted in multisystem organ failure and the patient died 16 days after the lobectomy.

Similar Cases:
Case 12, Case 54

References:

Title Page


Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Home | Search | About Us | FAQ | Reviews | Contact Us

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. [Google+ Profile] and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

URL: http://www.virtualpediatrichospital.org/

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.