Chronic septic granulomatosis revealed by neonatal pulmonary aspergillosis

Pulmonary aspergillosis is now the main cause of death in chronic granulomatous disease (CGD); it may occur before the age of one year and then often reveals CGD. A male newborn was referred to hospital at 27 days of age for fever (39 degrees C), hemodynamic failure and biological inflammation syndr...

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Bibliographic Details
Published in:Archives de pédiatrie : organe officiel de la Société française de pédiatrie 1995-09, Vol.2 (9), p.861-864
Main Authors: Mouy, R, Ropert, J C, Donadieu, J, Hubert, P, de Blic, J, Revillon, Y, Brunelle, F, Schollet Martin, S, Descamps, B, Debré, M
Format: Article
Language:fre
Subjects:
Aspergillosis - diagnostic imaging
Aspergillosis - etiology
Aspergillus fumigatus
Granulomatous Disease, Chronic - complications
Granulomatous Disease, Chronic - diagnostic imaging
Humans
Infant, Newborn
Lung Diseases, Fungal - diagnostic imaging
Lung Diseases, Fungal - etiology
Male
Radiography, Thoracic
Tomography Scanners, X-Ray Computed
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Summary:Pulmonary aspergillosis is now the main cause of death in chronic granulomatous disease (CGD); it may occur before the age of one year and then often reveals CGD. A male newborn was referred to hospital at 27 days of age for fever (39 degrees C), hemodynamic failure and biological inflammation syndrome caused by pulmonary infection. Chest CT scan revealed multiple and bilateral intraparenchymatous nodules. An open lung biopsy showed histiocystic granuloma with multinucleated giant cells. Culture of tracheal, bronchoalveolar lavage samples and lung biopsy grew positive for Aspergillus fumigatus. Impaired chemiluminescence production by neutrophils was detected, enabling the diagnosis of CGD. It was later confirmed by the study of neutrophils functions. The child recovered after 12 months of parenteral amphotericin B therapy. A febrile multifocal pneumopathy occurring in infancy should lead to consider the possibility of CGD which may be confirmed by the chemiluminescence test.
ISSN:0929-693X