Clin Pediatr Hematol Oncol.  2015 Oct;22(2):190-194. 10.15264/cpho.2015.22.2.190.

Invasive Pulmonary Aspergillosis after Recent Influenza in a Child with Acute Myeloid Leukemia

• Kim BJ
• Kim SK
• Han SB
• Lee JW
• Yoon JS
• Chung NG
• Cho B
• Kang JH
• Kim HK

• KMID: 2084624
• DOI: http://doi.org/10.15264/cpho.2015.22.2.190

Abstract

Respiratory viral infection has been reported as a risk factor for invasive pulmonary aspergillosis (IPA) in hematopoietic cell transplantation (HCT) recipients, and IPA following influenza has been reported. We report a 13-year-old boy diagnosed with IPA following influenza. He received allogeneic HCT and then received glucocorticoids for chronic graft-versus-host disease. On admission, he complained of non-neutropenic fever and dyspnea. He was diagnosed with influenza A via a polymerase chain reaction (PCR) test from nasopharyngeal swab, and oseltamivir was administered. Fever re-emerged nine days later and repeat PCR was positive for influenza A. His fever did not resolve despite triple antiviral and empirical antibiotic therapy. On hospital day 22, IPA was diagnosed based on chest computed tomography and positive serum galactomannan results, and his symptoms improved with voriconazole therapy. However, he died of uncontrolled bronchiolitis obliterans on hospital day 128. IPA should be considered a complication of influenza in immunocompromised children.

Keyword

Influenza; Invasive pulmonary aspergillosis; Hematopoietic stem cell transplantation; Acute myeloid leukemia; Child

MeSH Terms

Adolescent
Bronchiolitis Obliterans
Cell Transplantation
Child*
Dyspnea
Fever
Glucocorticoids
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Influenza, Human*
Invasive Pulmonary Aspergillosis*
Leukemia, Myeloid, Acute*
Male
Oseltamivir
Polymerase Chain Reaction
Risk Factors
Thorax
Transplants
Glucocorticoids
Oseltamivir