Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Aspergillus Laryngotracheobronchitis in a Child with Primary Immunodeficiency

  • Moon, Soo Young (Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Lee, Soyoung (Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, You Sun (Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Park, June Dong (Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Choi, Yu Hyeon (Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2020.05.24
  • Accepted : 2020.08.01
  • Published : 2020.12.25
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Abstract

Laryngotracheobronchitis (LTB) is a common disease in the pediatric population, and it is rarely caused by a fungal infection. Acute respiratory failure caused by fungal LTB mainly occurs in immunocompromised patients, and early diagnosis is closely associated with morbidity and mortality. However, an appropriate diagnosis is challenging for pediatricians because symptoms and signs of LTB caused by Aspergillus spp. are nonspecific. Here, we report a case of progressive respiratory failure caused by pseudomembranous LTB in a child with a suspicion of primary immunodeficiency and highlight the importance of an early investigation, especially in immunocompromised patients.

소아에서 후두기관지염이 진균에 의해 발생하는 경우는 매우 드물고 주로 선행 요인이 있는 환자에 보고된다. 또한, Aspergillus 감염에 의한 후두기관지염은 초기에 무증상이거나 가슴 X선 사진에서 특이점이 없는 경우가 많아 조기 진단이 어렵다. 저자는 피부증상과 비감염성 발열을 조절하기 위해 장기간 저용량 스테로이드를 사용했던 복용력이 있는 일차성 면역 결핍 질환이 의심되는 환자에서 점진적인 호흡 부전을 보였고 가막성 아르페르길루스증(Pseudomembranous aspergillosis)에 의한 후두기관지염으로 밝혀진 사례를 보고하여 Aspergillus 후두기관지염의 고위험 환자군에서 조기 진단을 통한 치료의 중요성을 알리고자 한다.

Keywords

References

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