Disseminated penicilliosis due to Penicillium chrysogenum in a pediatric patient with Henoch-Schönlein syndrome.
A case of disseminated infection caused by Penicillium chrysogenum in a 10-year-old boy with a history of Henoch-Schönlein purpura and proliferative glomerulonephritis, treated with immunosuppressors, is reported herein. The patient had a clinical picture of 2 weeks of fever that did not respond to treatment with broad-spectrum antibiotics and amphotericin B. Computed tomography imaging showed diffuse cotton-like infiltrates in the lungs, hepatomegaly, mesenteric lymphadenopathy, and multiple well-defined round hypodense lesions in the spleen. His treatment was changed to caspofungin, followed by voriconazole. One month later, a splenic biopsy revealed hyaline septate hyphae of >1μm in diameter. Fungal growth was negative. However, molecular analysis showed 99% identity with P. chrysogenum. A therapeutic splenectomy was performed, and treatment was changed to amphotericin B lipid complex and caspofungin. The patient completed 2 months of treatment with resolution of the infection. P. chrysogenum is a rare causative agent of invasive fungal infections in immunocompromised patients, and its diagnosis is necessary to initiate the appropriate antifungal treatment.
Department of Infectious Diseases, Hospital Infantil de México Federico Gómez, Dr. Márquez #162, Col. Doctores, Cuauhtémoc, 06720 Mexico City, Mexico. Electronic address: marmtom@hotmail.com.
Martha
M
Avilés-Robles
Department of Infectious Diseases, Hospital Infantil de México Federico Gómez, Dr. Márquez #162, Col. Doctores, Cuauhtémoc, 06720 Mexico City, Mexico.
Carlos
C
Gómez-Ponce
Laboratory of Mycology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Jesús
J
Reséndiz-Sánchez
Department of Microbiology, ENCB, Instituto Politécnico Nacional, Mexico City, Mexico.
Aída Verónica
AV
Rodríguez-Tovar
Department of Pediatrics, Centro Medico Dalinde, Mexico City, Mexico.
Adrián
A
Ceballos-Bocanegra
Department of Microbiology, ENCB, Instituto Politécnico Nacional, Mexico City, Mexico.
Ángeles
Á
Martínez-Rivera
D000666:Amphotericin B / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D000077336:Caspofungin; D002648:Child; D054714:Echinocandins / Q000627:therapeutic use; D005334:Fever; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D060605:Hyalohyphomycosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D011695:IgA Vasculitis / Q000150:complications; D016867:Immunocompromised Host; D007676:Kidney Failure, Chronic / Q000150:complications; D055666:Lipopeptides / Q000627:therapeutic use; D008297:Male; D010408:Penicillium chrysogenum / Q000187:drug effects / Q000302:isolation & purification*; D013154:Spleen / Q000382:microbiology / Q000473:pathology; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D065819:Voriconazole / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077336:Caspofungin; D065819:Voriconazole
Disseminated penicilliosis; Hyalohyphomycosis; Penicilliosis; Penicillium chrysogenum