The first rare and fatal case of invasive aspergillosis of spinal cord due to Aspergillus nidulans in an Iranian child with chronic granulomatosis disease: review of literature

Mahin  Tavakoli; Mohammad Taghi   Hedayati; Hossein  Mirhendi; Sadegh   Nouripour-Sisakht; Newsha  Hedayati; Fatemeh Saghafi; Setareh  Mamishi

doi:10.18502/cmm.6.1.2551

Mahin Tavakoli
Mohammad Taghi Hedayati
Hossein Mirhendi
Sadegh Nouripour-Sisakht
Newsha Hedayati
Fatemeh Saghafi
Setareh Mamishi

DOI: https://doi.org/10.18502/cmm.6.1.2551

Keywords: Aspergillus nidulans Chronic granulomatosis disease Invasive aspergillosis Spinal cord

Abstract

Background and Purpose: Invasive aspergillosis (IA) of the central nervous system (CNS) is a devastating complication which is rarely reported in immunocompromised children.
In this case presentation, we reported a rare and fatal IA with spinal cord involvement in a 10-year-old child with X-linked chronic granulomatosis disease (CGD).

Case report: The child had a previous history of pulmonary tuberculosis. A cervical spine X-ray revealed the involvement of cervical vertebrae (T4/T5) and ribs causing spinal cord compression and epidural abscess. The patient underwent a decompressive laminectomy and mass removal. The histopathology and culture results suggested IA. Despite the aggressive and prolonged therapy, he died within one year. Aspergillus nidulans was identified as the causative agent based on morphological and molecular studies.

Conclusion: This synopsis represents the aggressive behavior of infection caused by A. nidulans in the CGD patient.