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Pediatric Radiology

, Volume 33, Issue 7, pp 453–460 | Cite as

The radiological spectrum of invasive aspergillosis in children: a 10-year review

  • Karen E. Thomas
  • Catherine M. Owens
  • Paul A. Veys
  • Vas Novelli
  • Vera Costoli
Original Article

Abstract

Background

Invasive aspergillosis is an uncommon but life-threatening event in the immunocompromised child. Attempts at fungal isolation are often unrewarding and a high index of radiological suspicion is essential in the early diagnosis of infected children.

Objective

To document the radiological spectrum of disease in invasive aspergillosis in the paediatric population.

Materials and methods

A retrospective review of the imaging performed in 27 consecutive patients (age 7 months to 18 years) with documented invasive Aspergillosis encountered over a 10-year period at a single institution.

Results

Radiographic findings of pulmonary disease (20 patients) included segmental and multilobar consolidation, perihilar infiltrates, multiple small nodules, peripheral nodular masses and pleural effusions. No cavitating lesions were seen on CXR. Small cavitating nodules were present on CT in two of eight children. Chest wall disease was particularly associated with underlying chronic granulomatous disease. Disseminated disease manifested as osteomyelitis (n=5), cerebral (n=3), oesophageal (n=1), hepatic (n=2), renal (n=2) and cutaneous (n=5) involvement. Imaging findings are discussed. Twelve patients (44%) subsequently died from Aspergillus-related complications.

Conclusions

Invasive aspergillosis presents with a wide variety of radiographic findings involving multiple organ systems. Respiratory findings are varied but often non-specific, and a high index of suspicion is necessary in immunocompromised patients. In contrast to adult disease, the incidence of cavitation of pulmonary lesions appears low.

Keywords

Children Lung Infection Aspergillosis Immunodeficiency Radiography CT 

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Karen E. Thomas
    • 1
    • 2
  • Catherine M. Owens
    • 1
  • Paul A. Veys
    • 3
  • Vas Novelli
    • 3
  • Vera Costoli
    • 3
  1. 1.Department of Diagnostic RadiologyGreat Ormond Street Hospital for Children
  2. 2.Department of Diagnostic RadiologyThe Hospital for Sick Children
  3. 3.Host Defence UnitGreat Ormond Street Hospital for Children

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