Fatal Nasal Aspergillosis in an Immunocompromised Pediatric Patient

Abstract

2-year-old female patient with no personal or family history of interest, admitted to the Pediatric Intensive Care Unit complicated with aortitis and facing a complicated postsurgical process after open heart surgery, managed with steroid pulses, patient maintains severe leukopenia and zero neutrophil count.
It debuts with a flattened violaceous lesion at the nasal level accompanied by discrete whitish eschars that within 48 hours become a necrotic lesion, with negative bacterial cultures. A biopsy was taken from said lesion that showed histological findings corresponding to Aspergillus sp. He died 60 hours later. of the onset of the injury.

Invasive aspergillosis is a complication that can be seen in immunocompromised children, with a poorly known incidence rate in patients outside the use of chemotherapy1,3. Sustained neutropenia is identified as a major risk factor. In addition to the use of high-dose steroids, the application of amphotericin B nasal spray is recommended in patients who show sustained neutropenia. It can become a fatal case and end in migration to the lungs and brain; lung involvement must be taken into account as a predictor of mortality. Management with amphotericin B and voriconazole constitute the basis of treatment.