Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Clinical History:
The patient was an 8 year old female status post bone marrow
transplant for myelodysplastic syndrome 33 days ago who developed a
cough.
Clinical Physical Exam:
Non-productive cough.
Clinical Labs:
Non-contributory
Clinical Differential Diagnosis:
Aspergillosis, Pneumocystic Carinii Pneumonia
Imaging Findings:
Chest films demonstrated a lesion in the right lung which was
confirmed on a chest CT exam performed 3 days later.
Imaging Differential Diagnosis:
Aspergilloma
Operative Findings:
Three days after the chest CT exam the patient underwent a
thoracotomy and wedge resection of the right lower lobe to remove the
aspergilloma. The lesion was found to be in the apical segment of the
right lower lobe.
Pathological Findings:
Pulmonary infarction with cavitation and fungal overgrowth were seen.
Angioinvasive septate branching hyphae, consistent with
aspergillosis, were also seen.
Final Diagnosis:
Aspergillosis
Follow-up and Prognosis:
The patient had an uncomplicated post-operative course. She was
placed on amphotericin and then switched to itraconazole.
Similar Cases:
Case 26,
Case 54
References:
Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
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