Aspergillosis in Chronic Granulomatous Disease: Therapeutic Considerations

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Abstract
Children with chronic granulomatous disease (CGD) are susceptible to a wide variety of catalase-positive microorganisms.1Aspergillus infections are particularly difficult to diagnose and treat. Aspergilli may invade many tissues, including the lung,1,2 thyroid,3 and bone,4 and diagnosis frequently requires culture of surgical specimens. Therapy for aspergillosis in children with CGD by use of amphotericin B alone is frequently suboptimal, and several patients have required granulocyte transfusions in addition to amphotericin B.1,2 The need for potentially synergistic combinations of antimicrobials is particularly keen in children with CGD. We report a case of aspergillosis involving the ribs, lung, and pleura that was successfully treated with the combination of amphotericin B and rifampin. Method of Susceptibility Testing.—The clinical isolate of A fumigatus was grown on Sabouraud's ager slants for seven days. The method of harvesting and quantitating the inocula of the aspergillus and the control organism Candida