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Surgical Management of an Aspergillus Empyema in a 3-Year-Old Child

Meletios A Kanakis1, Konstantinos Th Petsios2, Nicholas M Giannopoulos1

  • 1Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Center, Athens, Greece.

Case Reports in Medicine
|May 27, 2020
PubMed

Insights

Invasive aspergillosis causing empyema is rare in healthy children. Early surgical intervention and prolonged antifungal therapy, like voriconazole, are crucial for managing this severe respiratory condition.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Surgical Case Reports

Background:

  • Invasive aspergillosis leading to empyema is exceptionally rare in immunocompetent pediatric patients.
  • Prompt recognition and management are critical due to potential for rapid clinical deterioration.

Observation:

  • A previously healthy 3-year-old child presented with severe respiratory distress and instability, initially misdiagnosed as sepsis.
  • Surgical intervention was required, followed by a diagnosis of invasive aspergillosis.

Findings:

  • Post-surgical intravenous voriconazole therapy resulted in a stable condition with minor residual respiratory deficits.
  • Delayed diagnosis and the need for urgent surgical management highlight the challenges in treating pediatric Aspergillus empyema.

Implications:

  • This case underscores the importance of considering invasive fungal infections in pediatric respiratory failure.
  • Aggressive, prolonged antifungal treatment with close monitoring is essential for favorable outcomes in invasive aspergillosis.
  • Early diagnosis and surgical intervention are vital when invasive aspergillosis presents as empyema in children.

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