The research team of Associate Professor Zhongqiang Liu of the Pediatric Intensive Care Unit at West China Second University Hospital, Sichuan University, published a clinical case report entitled "Chronic cavitary pulmonary aspergillosis in an infant" in The Lancet Infectious Diseases in December 2021.
Chronic cavitary pulmonary aspergillosis (CCPA) is a chronic pulmonary aspergillosis (CPA) characterized by the formation of pulmonary cavities. CPA has several clinical manifestations, including pulmonary aspergillus ball, aspergillus nodule, chronic cavitary pulmonary aspergillosis and chronic fibrotic pulmonary aspergillosis.
According to the literature, CCPA patients are generally adults aged 20 to 80. Cavitary and fibrotic forms of CPA usually progress slowly (months or years) and are rarely reported in children. Only Stojnic N reported a 10-year-old child suffering from chronic necrotizing pulmonary aspergillosis in 2014, and no other infant cases were reported. According to the author, “A 7-month-old girl was admitted to the Pediatric Intensive Care Unit at West China Second University Hospital (Chengdu, China) with a recurrent cough for over 3 months, aggravated with fever and dyspnoea for 4 days before presentation. Physical examination revealed rough respiratory sounds, with crackles in both lungs. --- On day 5, the patient developed haemoptysis (5 mL). Her respiratory status progressively deteriorated and endotracheal intubation was required. Although there was no direct experimental evidence of fungal infection, the diagnosis of chronic cavitary pulmonary aspergillosis was suspected, based on the CT findings and clinical symptoms. The patient was treated with antifungal oral voriconazole (0·07 g every 12 h) for 3 months and her clinical and radiographic condition improved. Finally, the diagnosis of chronic cavitary pulmonary aspergillosis was confirmed by positivity of aspergillus-specific IgG assay.”
Pulmonary fungal infection is one of the common diseases endangering children's lives. The early detection, diagnosis and treatment of CCPA is very important to prevent the deterioration of the disease and reduce the risk of death in children. This case report can provide clues for the diagnosis and treatment of patients in the future. They help doctors expand their thinking, gradually move from ignorance to clarity, and promote medical progress via real life medical cases.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00351-0/fulltext
