Şişli Emrah, Özdemir Şahan Yasemin, Ayık Mehmet Fatih, Nart Deniz, Atay Yüksel
Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
Turk Kardiyol Dern Ars. 2017 Oct;45(7):660-663. doi: 10.5543/tkda.2017.52284.
A 3-year-old girl with the diagnosis of chronic granulomatous disease (CGD) was hospitalized for bronchopneumonia and congestive heart failure. Her medical history included methylprednisolone medication for autoimmune gastric outlet obstruction. Computed tomography revealed pneumonic infiltrations and pericardial thickening. A pulsed-wave Doppler recording revealed E/A >1. During a pericardiectomy, multiple islands of thick, firm-walled, fibrinous exudate-containing, small abscess formations were observed. Histopathological evaluation of pericardial tissue revealed granulomatous inflammation. Aspergillus fumigatus was cultured from the abscess. In conclusion, development of constrictive aspergillus pericarditis should be considered in patients with CGD because immediate initiation of antifungal management with aggressive surgical treatment is life-saving.
一名诊断为慢性肉芽肿病（CGD）的3岁女孩因支气管肺炎和充血性心力衰竭住院。她的病史包括因自身免疫性胃出口梗阻接受甲基强的松龙治疗。计算机断层扫描显示肺部浸润和心包增厚。脉冲波多普勒记录显示E/A>1。在心包切除术中，观察到多个含有厚壁、坚实、纤维蛋白渗出物的小岛状小脓肿形成。心包组织的组织病理学评估显示肉芽肿性炎症。从脓肿中培养出烟曲霉。总之，CGD患者应考虑发生缩窄性曲霉性心包炎，因为立即启动抗真菌治疗并积极进行手术治疗可挽救生命。
