One-Month-Old Infant With Multilobar Round Pneumonias

Kosut, Jessica; Kamani, Naynesh; Jantausch, Barbara

doi:10.1097/01.inf.0000195717.40250.8b

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Despite accumulation of neutrophils, however, fungal hyphae remain intact due to the attenuation of microbicidal activity of host phagocytes [4,39,79,157]. Recently, the aberrant and persistent inflammatory response of CGD patients to a variety of infectious stimuli was found to be associated with delayed apoptosis of neutrophils and deficient production of the anti-inflammatory mediators prostaglandin D 2 and transforming growth factor-β [9,18].…”

Section: Aspergillus Infections In Cgd Patientsmentioning

confidence: 97%

Fungal infections in primary immunodeficiencies

2007

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Patients with phagocytic, cellular, combined and other primary immunodeficiencies exhibit immune deficits that confer increased susceptibility to fungal infections. A number of yeasts and moulds, most commonly Candida and Aspergillus but also Cryptococcus, Histoplasma, Paecilomyces, Scedosporium, Trichosporon, Penicillium and other, rarely isolated, fungal organisms, have been variably implicated in causing disease in patients with chronic granulomatous disease, severe combined immunodeficiency, chronic mucocutaneous candidiasis, hyper-IgE syndrome, myeloperoxidase deficiency, leukocyte adhesion deficiency, defects in the interferon-gamma/interleukin-12 axis, DiGeorge syndrome, X-linked hyper-IgM syndrome, Wiskott-Aldrich syndrome and common variable immunodeficiency. Differences in the spectrum of fungal pathogens as well as in the incidence and clinical presentation of the infections may be observed among patients, depending upon different immune disorders. Fungal infections in these individuals may occasionally be the presenting clinical manifestation of a primary immunodeficiency and can cause significant morbidity and potentially fatal outcome if misdiagnosed or mistreated. A high degree of suspicion is needed and establishment of diagnosis should actively be pursued using appropriate imaging, mycological and histological studies. A number of antifungal agents introduced over the last fifteen years, such as the lipid formulations of amphotericin B, the second-generation triazoles, and the echinocandins, increase the options for medical management of these infections. Surgery may also be needed in some cases, while the role of adjunctive immunotherapy has not been systematically evaluated. The low incidence of primary immunodeficiencies in the general population complicates single-center prospective or retrospective clinical studies aiming to address diagnostic or therapeutic issues pertaining to fungal infections in these patients.

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Section: Aspergillus Infections In Cgd Patientsmentioning

confidence: 97%

Fungal infections in primary immunodeficiencies

2007

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“…Chest wall invasion by pathogens has also been described [40] and may be due to necrotizing infections by fungi such as Aspergillus [41]. Pulmonary infections have also been described due to Pneumocystis carinii [42-44], Cryptococcus neoformans [45], Aspergillus [41,46-50], visceral Leishmaniasis [51], suppurative pathogens [52], Pseudomonas cepacia [53,54], [55], Legionella [56,57], Nocardia [58-61], Mycoplasma pneumoniae [62], Sarcinosporon inkin -a skin fungus [63], Tuberculosis [64], Trichosporon pullulans [65,66], Tularemia [67], Q Fever [68], Acremonium kiliense [69], Botryomycosis [70], Chrysosporium zonatum [71], Burkholderia (Pseudomonas) gladioli [72], fulminant mulch/filamentous fungi [73], Respiratory Syncitial Virus [74], and Francisella philomiragia (formerly Yersinia philomiragia ) [75]. Certain pneumonic variants have also been described in CGD, including crystalline, nodular, and eosinophilic pneumonias [76,77].…”

Section: Clinical Aspectsmentioning

confidence: 99%

Chronic granulomatous disease: a review of the infectious and inflammatory complications

et al. 2011

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Chronic Granulomatous Disease is the most commonly encountered immunodeficiency involving the phagocyte, and is characterized by repeated infections with bacterial and fungal pathogens, as well as the formation of granulomas in tissue. The disease is the result of a disorder of the NADPH oxidase system, culminating in an inability of the phagocyte to generate superoxide, leading to the defective killing of pathogenic organisms. This can lead to infections with Staphylococcus aureus, Psedomonas species, Nocardia species, and fungi (such as Aspergillus species and Candida albicans). Involvement of vital or large organs can contribute to morbidity and/or mortality in the affected patients. Major advances have occurred in the diagnosis and treatment of this disease, with the potential for gene therapy or stem cell transplantation looming on the horizon.

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“…Some of these agents present as multifocal, round pulmonary lesions on radiographs. Kosut et al [13] and Shetty et al [14] reported cases of round pneumonias in patients with chronic granulomatous disease. The case reported by Kosut was that of a newborn with multilobar round pneumonias.…”

Section: Pulmonary Infectionsmentioning

confidence: 99%

Imaging of round pneumonia and mimics in children

et al. 2010

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Various diseases in the pediatric age group can present as an intrathoracic rounded opacity on a chest radiograph. The purpose of this pictorial essay is to emphasize the imaging appearance of round pneumonia, an entity that occurs especially in the pediatric population. Additional pathologies with similar chest radiographic appearances are also presented. The diagnosis of round pneumonia should be made in children who have the typical clinical presentation along with chest radiographs demonstrating the characteristic findings.

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One-Month-Old Infant With Multilobar Round Pneumonias

Cited by 9 publications

References 5 publications

Fungal infections in primary immunodeficiencies

Fungal infections in primary immunodeficiencies

Chronic granulomatous disease: a review of the infectious and inflammatory complications

Imaging of round pneumonia and mimics in children

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