title: Chronic granulomatous disease in an adult recognized by an invasive aspergillosis.
abstract: A 20-year-old man without any history of a pulmonary disease presented initially with a 1-day history of fever and tachypnea and developed an acute respiratory failure within 24 hours. Microbiological and histological examinations raised an invasive pulmonary aspergillosis (IPA). A chronic granulomatous disease was identified as the predisposing factor leading to this severe fungal infection. Chronic granulomatous disease is caused by a reduced ability of phagocytes to mount an oxidative burst due to a defect in the nicotinamide adenine dinucleotide phosphate oxidase. Although IPA occurs usually in severely immunocompromised patients, it should be kept in mind that there are an increasing number of cases developing IPA in the setting of apparent health or to date undiagnosed immunodeficiency that requires further diagnostics.
authors.affiliation: Clinic of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany. Electronic address: ines.kaufmann@med.uni-muenchen.de.
authors.forename: Ines
authors.initials: I
authors.lastname: Kaufmann
authors.affiliation: Clinic of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Josef
authors.initials: J
authors.lastname: Briegel
authors.affiliation: Clinic of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: van der Heide
authors.affiliation: Clinic of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Chouker
authors.affiliation: Clinic of Anesthesiology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Frey
authors.affiliation: Clinic of Medicine III, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Spiekermann
authors.affiliation: Department of Pathology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Mayr
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, University of Heidelberg, Mannheim, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Thiel
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001230:Aspergillus / Q000187:drug effects / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D005858:Germany; D006105:Granulomatous Disease, Chronic / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics; D006801:Humans; D007263:Infusions, Parenteral; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy*; D017964:Itraconazole / Q000627:therapeutic use; D008168:Lung / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D008297:Male; D008562:Membrane Glycoproteins / Q000235:genetics; D000074662:NADPH Oxidase 2; D019255:NADPH Oxidases / Q000235:genetics; D010586:Phagocytes / Q000737:chemistry; D011743:Pyrimidines / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D059246:Tachypnea / Q000503:physiopathology; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D008562:Membrane Glycoproteins; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; C056558:CYBB protein, human; D000074662:NADPH Oxidase 2; D019255:NADPH Oxidases; D065819:Voriconazole