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Case Reports
. 2019 Dec 22;9(1):15.
doi: 10.3390/pathogens9010015.

A Peculiar Case of Pneumonia due to Mycoplasma pneumoniae in a Child with Cystic Fibrosis and Sensibilization to Aspergillus fumigatus

Laura Peccini  1 , Serena Pennoni  1 , Valeria Mencarini  2 , Marco Saponara  1 , Nicola Palladino  2 , Nicola Principi  3 , Guido Pennoni  2 , Susanna Esposito  4
Affiliations
Case Reports

A Peculiar Case of Pneumonia due to Mycoplasma pneumoniae in a Child with Cystic Fibrosis and Sensibilization to Aspergillus fumigatus

Laura Peccini et al. Pathogens. .

Abstract

Aspergillus fumigatus plays a major role in pulmonary exacerbations in patients with cystic fibrosis. The most common A. fumigatus diseases are those based on immune-mediated response to A. fumigatus antigens; including allergic bronchopulmonary aspergillosis (ABPA). In this condition; the presence of A. fumigatus in the lower respiratory tract triggers an IgE-mediated hypersensitivity response that causes airway inflammation; bronchospasms; and bronchiectasis. This case report describes a ten-year-old male patient suffering from cystic fibrosis (CF) in whom the diagnosis of ABPA occurred in association with pneumonia due to Mycoplasma pneumoniae more than two weeks after hospitalization. This case is a good example of how difficult the identification of ABPA in CF patients can be and highlights that ABPA can occur in association with co-infections due to other pathogens. In order to avoid the risk of a late ABPA diagnosis, it is imperative that the diagnostic criteria guidelines are reviewed and standardized.

Keywords: Aspergillus fumigatus; allergic bronchopulmonary aspergillosis; antimicrobial resistance; cystic fibrosis; pneumonia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Computed tomography of bilateral bronchiectasis/bronchiolectasis with material in the context, suggesting high-attenuation mucus plugs.
Figure 2
Figure 2
Chest X-ray evolution before allergic bronchopulmonary aspergillosis (ABPA) diagnosis (A) and one month after treatment (B).
See this image and copyright information in PMC

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