Abstract
A 3-year-old girl with the diagnosis of chronic granulomatous disease (CGD) was hospitalized for bronchopneumonia and congestive heart failure. Her medical history included methylprednisolone medication for autoimmune gastric outlet obstruction. Computed tomography revealed pneumonic infiltrations and pericardial thickening. A pulsed-wave Doppler recording revealed E/A >1. During a pericardiectomy, multiple islands of thick, firm-walled, fibrinous exudate-containing, small abscess formations were observed. Histopathological evaluation of pericardial tissue revealed granulomatous inflammation. Aspergillus fumigatus was cultured from the abscess. In conclusion, development of constrictive aspergillus pericarditis should be considered in patients with CGD because immediate initiation of antifungal management with aggressive surgical treatment is life-saving.
MeSH terms
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Antifungal Agents / administration & dosage
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Antifungal Agents / therapeutic use
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Aspergillosis / drug therapy
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Aspergillosis / etiology*
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Aspergillosis / surgery
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Aspergillus fumigatus / isolation & purification*
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Bronchopneumonia / diagnostic imaging
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Bronchopneumonia / drug therapy
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Bronchopneumonia / microbiology
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Bronchopneumonia / surgery
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Child, Preschool
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Echocardiography
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Echocardiography, Doppler, Pulsed
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Female
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Granulomatous Disease, Chronic / complications*
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Granulomatous Disease, Chronic / drug therapy
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Humans
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Interferon-gamma / administration & dosage
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Interferon-gamma / therapeutic use
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Pericarditis, Constrictive / diagnostic imaging
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Pericarditis, Constrictive / drug therapy
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Pericarditis, Constrictive / etiology*
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Pericarditis, Constrictive / surgery
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Pericardium / pathology
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Radiography, Thoracic
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Recombinant Proteins / administration & dosage
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Recombinant Proteins / therapeutic use
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Tomography, X-Ray Computed
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Voriconazole / administration & dosage
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Voriconazole / therapeutic use
Substances
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Antifungal Agents
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Recombinant Proteins
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interferon gamma-1b
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Interferon-gamma
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Voriconazole