The first rare and fatal case of invasive aspergillosis of spinal cord due to Aspergillus nidulans in an Iranian child with chronic granulomatosis disease: review of literature

Document Type: Case report

Authors

1 Student Research Committee, Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran

2 Invasive Fungi Research Center, Mazandaran University of Medical Sciences, Sari, Iran

3 Department of Medical Mycology and Parasitology, Isfahan University of Medical Sciences, Isfahan, Iran

4 Cellular and Molecular Research center, Yasuj University of Medical Sciences, Yasuj, Iran

5 Student Research Committee, Invasive Fungi Research Center, Sari, Iran

6 Department of Clinical pharmacy, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

7 Department of Infectious Diseases, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background and Purpose: Invasive aspergillosis (IA) of the central nervous system (CNS) is a devastating complication which is rarely reported in immunocompromised children.
In this case presentation, we reported a rare and fatal IA with spinal cord involvement in a 10-year-old child with X-linked chronic granulomatosis disease (CGD).
Case report: The child had a previous history of pulmonary tuberculosis. A cervical spine X-ray revealed the involvement of cervical vertebrae (T4/T5) and ribs causing spinal cord compression and epidural abscess. The patient underwent a decompressive laminectomy and mass removal. The histopathology and culture results suggested IA. Despite the aggressive and prolonged therapy, he died within one year. Aspergillus nidulans was identified as the causative agent based on morphological and molecular studies.
Conclusion: This synopsis represents the aggressive behavior of infection caused by A. nidulans in the CGD patient.

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