Chronic pulmonary aspergillosis associated to multiple airway papillomatosis: Case-report and literature review

Abstract

Background: Aspergillosis is rare in children, although Aspergillus species cause a wide spectrum of diseases. The host immune system is a major determinant in the development of particular forms of aspergillosis, such as acute invasive pulmonary aspergillosis, allergic bronchopulmonary aspergillosis, aspergilloma and chronic pulmonary aspergillosis (CPA).

Objective: Present experience in the management of CPA in a patient with pulmonary papillomatosis. 

Case: 8 years-old girl with pulmonary papillomatosis, treated with laser surgery and topic Mitomicin at different periods, without complete resolution. She presents frequent pulmonary infectious exacerbations; in the last one Aspergillus fumigatus was isolated in 6 cultures. The chest X-ray and tomography show multiple pulmonary cavities in the right upper lobe, leading to the diagnosis of CPA. The patient received therapy with Itraconazol, achieving clinical-radiological success and negative cultures. 

Conclusions: CPA is rare in children, however, it is necessary an early diagnosis in order to establish the adequate therapy that avoids pulmonary fibrosis and respiratory insufficiency.