Lochan Harsha, Naicker Preneshni, Maphanga Tsidiso, Ryan Anthea, Pillay Komala, Govender Nelesh P, Eley Brian
Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital, South Africa.
Department of Paediatrics and Child Health, University of Cape Town, South Africa.
South Afr J HIV Med. 2015 Jun 11;16(1):352. doi: 10.4102/sajhivmed.v16i1.352. eCollection 2015.
Opportunistic fungal infections can cause significant morbidity and mortality in immunocompromised patients. We describe a paediatric case of an unusual disseminated fungal infection. A three-year-old HIV-infected child with severe immunosuppression (CD4+ T-cell count 12 × 10/L) was admitted to hospital with pneumonia, gastroenteritis and herpes gingivostomatitis. Despite antibacterial and antiviral therapy, he experienced high fevers and developed an erythematous maculopapular rash and abdominal tenderness. The child's condition progressively worsened during the admission. A thermally dimorphic fungus was cultured from bone marrow and identified as an Emmonsia species on DNA sequencing. The patient made a good recovery on amphotericin B deoxycholate and antiretroviral therapy. Itraconazole was continued for a minimum of 12 months, allowing for immune reconstitution to occur. This case is the first documented description of disseminated disease caused by a novel Emmonsia species in an HIV-infected child in South Africa.
机会性真菌感染可导致免疫功能低下患者出现严重的发病和死亡情况。我们描述了一例儿童罕见播散性真菌感染病例。一名3岁感染HIV且免疫严重抑制（CD4 + T细胞计数为12×10/L）的儿童因肺炎、肠胃炎和疱疹性龈口炎入院。尽管接受了抗菌和抗病毒治疗，但他仍持续高烧，出现了红斑丘疹性皮疹和腹部压痛。患儿在住院期间病情逐渐恶化。从骨髓中培养出一种温度双相真菌，经DNA测序鉴定为埃蒙斯菌属。患者在接受脱氧胆酸盐两性霉素B和抗逆转录病毒治疗后恢复良好。继续使用伊曲康唑至少12个月，以实现免疫重建。该病例是南非首例记录在案的由新型埃蒙斯菌属引起的HIV感染儿童播散性疾病描述。
