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Related Experiment Videos

Invasive aspergillosis in children.

E S Golladay, S B Baker

    Journal of Pediatric Surgery
    |June 1, 1987
    PubMed
    Summary

    Invasive aspergillosis in immunocompromised children can present as severe soft tissue infections, not just sinus or lung issues. Early diagnosis via biopsy and radical surgical debridement are crucial for survival.

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    Area of Science:

    • Medical Mycology
    • Pediatric Infectious Diseases
    • Surgical Pathology

    Background:

    • Invasive aspergillosis is a severe complication in immunocompromised children, often presenting as sinus or pulmonary infections.
    • A significant proportion of these cases remain undiagnosed premortem, contributing to high mortality rates despite treatment.

    Observation:

    • This study reports on four immunocompromised children with invasive aspergillosis presenting with extensive soft tissue infections, distinct from typical presentations.
    • Three cases involved traumatic leg injuries with significant contamination, and one occurred in a child with acute lymphocytic leukemia and neutropenia.
    • All patients developed characteristic punctate black skin lesions with erythema, rapidly progressing despite initial debridement and amphotericin B therapy.

    Findings:

    • Histological examination revealed vascular invasion by fungal hyphae in all cases.
    • Aggressive surgical intervention, including hemipelvectomies and chest wall resection, led to positive responses.
    • Early biopsy of suspicious skin lesions is vital for identifying characteristic hyphal forms.

    Implications:

    • Invasive aspergillosis should be considered in immunocompromised children with unexplained soft tissue lesions, especially following trauma or with neutropenia.
    • Prompt radical surgical debridement combined with antifungal therapy offers a potentially lifesaving approach.
    • The initial surgical approach must encompass tissue beyond the visibly affected areas to ensure complete removal.

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