Misleading Presentation of Tuberculosis in a Child With Cgd Revealing Invasive Aspergillosis: A Molecularly Confirmed Case Publisher



Aghajani M ; Parvaneh N ; Mahmoudi S ; Khansari M ; Haghighat F ; Sarvestani KK ; Mirsaid RG ; Sarvestani HK
Source: IDCases Published:2026

Abstract

Background and Purpose: Patients with chronic granulomatous disease (CGD) are susceptible to serious infections including, invasive aspergillosis (IA), which remains a major cause of morbidity and mortality. The diagnosis and management are often challenging due to overlapping clinical features and variable treatment responses. Case report: Here we report a 4-year-old girl with CGD who admitted with cellulitis, a chest wall abscess, and fever. She had a history of recurrent pneumonia since infancy and a prior diagnosis of tuberculosis (TB). Despite broad-spectrum antibacterial, her condition did not improve. Direct microscopic and macroscopic investigations revealed fungal infection with Aspergillus species. Conclusion: Molecular identification confirmed the isolates as A. fumigatus. According to the antifungal susceptibility testing, amphotericin B and posaconazole demonstrated strongest activity and the patient was successfully treated by liposomal amphotericin B (50 mg/day) and caspofungin (35 mg/day). © 2026