A case of emmonsiosis in an HIV-infected child

Area of Science:

• Mycology
• Infectious Diseases
• Pediatrics

Background:

• Opportunistic fungal infections pose significant risks to immunocompromised individuals, particularly children with HIV.
• Disseminated fungal infections can lead to severe morbidity and mortality.

Purpose of the Study:

• To report the first documented case of disseminated disease caused by a novel Emmonsia species in an HIV-infected child in South Africa.
• To highlight the diagnostic and therapeutic challenges of rare fungal infections in pediatric patients with severe immunosuppression.

Main Methods:

• A three-year-old HIV-infected child with severe immunosuppression presented with pneumonia, gastroenteritis, and herpes gingivostomatitis.
• Bone marrow culture and DNA sequencing were used to identify the causative fungus as an Emmonsia species.
• Treatment involved amphotericin B deoxycholate, antiretroviral therapy, and prolonged itraconazole therapy.

Main Results:

• The patient experienced high fevers, a maculopapular rash, and abdominal tenderness despite initial antibacterial and antiviral treatment.
• Culture and DNA sequencing confirmed a novel Emmonsia species as the cause of disseminated fungal infection.
• The child showed significant improvement with appropriate antifungal and antiretroviral therapy.

Conclusions:

• Disseminated Emmonsia species infection is a rare but serious opportunistic infection in severely immunocompromised HIV-infected children.
• Prompt diagnosis through mycology and effective treatment with antifungals and antiretroviral therapy are crucial for patient recovery.
• Long-term antifungal therapy aids immune reconstitution and prevents relapse in such cases.