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Órgano Oficial del Instituto Nacional de Pediatría

2006, Number 2

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Acta Pediatr Mex 2006; 27 (2)

Semi-invasive pulmonary aspergillosis in a patient with juvenile dermatomyositis

Zarco RJ, Carbajal RL, Vázquez TO, Rodríguez HR, Reynés MJN

Language: Spanish
References: 15
Page: 60-65
PDF size: 178.24 Kb.


ABSTRACT

Juvenile dermatomyositis (JDM) is a systemic disease among the group of idiopathic inflammatory myopathies. Semi-invasive pulmonary aspergillosis is a necrotising pneumonia, with subacute course, and mycotic invasion to the pulmonary vascular system with secondary hemorrhagic infarctions. It has been reported in children with systemic lupus erythematosus and polyarteritis nodosa who are being treated with steroids. We present the case of an 11 year-old boy with JDM. He was treated with high doses of steroids which improved his condition. However one month later he presented with right parahiliar pneumonia. Direct examination of the sputum, showed aspergillus mycelia. Sabouraud culture showed Aspergillus fumigatus; and a positive galactomanan antigen. He was treated with anfotericin B, itraconazol and steroids were gradually reduced. He had a favourable course. Conclusion. It is important to suspect this mycotic pulmonary infection in immunocompromised patients when remodelling hospitals, like it happened in this case. Antimycotic treatment improves the prognosis as in our patient.


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