Fulminant mulch pneumonitis: an emergency presentation of chronic granulomatous disease.

Fulminant mulch pneumonitis: an emergency presentation of chronic granulomatous disease. Research Abstract Details 

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Fulminant mulch pneumonitis: an emergency presentation of chronic granulomatous disease. Abstract Text:

Sophia Siddiqui,Victoria L Anderson,Diane M Hilligoss,Mario Abinun,Taco W Kuijpers,Henry Masur,Frank G Witebsky,Yvonne R Shea,John I Gallin,Henry L Malech,Steven M Holland,Sophia Siddiqui,Victoria L Anderson,Diane M Hilligoss,Mario Abinun,Taco W Kuijpers,Henry Masur,Frank G Witebsky,Yvonne R Shea,John I Gallin,Henry L Malech,Steven M Holland,

BACKGROUND: Chronic granulomatous disease (CGD) is associated with multiple and recurrent infections. In patients with CGD, invasive pulmonary infection with Aspergillus species remains the greatest cause of mortality and is typically insidious in onset. Acute fulminant presentations of fungal pneumonia are catastrophic. METHODS: Case records, radiograph findings, and microbiologic examination findings of patients with CGD who had acute presentations of dyspnea and diffuse pulmonary infiltrates caused by invasive fungal infection were reviewed and excerpted onto a standard format. RESULTS: From 1991 through 2004, 9 patients who either were known to have CGD or who received a subsequent diagnosis of CGD presented with fever and new onset dyspnea. Eight patients were hypoxic at presentation; bilateral pulmonary infiltrates were noted at presentation in 6 patients and developed within 2 days after initial symptoms in 2 patients. All patients received diagnoses of invasive filamentous fungi; 4 patients had specimens that also grew Streptomyces species on culture. All patients had been exposed to aerosolized mulch or organic material 1-10 days prior to the onset of symptoms. Cases did not occur in the winter. Five patients died. Two patients, 14 years of age and 23 years of age, who had no antecedent history of recognized immunodeficiency, were found to have p47(phox)-deficient CGD. CONCLUSIONS: Acute fulminant invasive fungal pneumonia in the absence of exogenous immunosuppression is a medical emergency that is highly associated with CGD. Correct diagnosis has important implications for immediate therapy, genetic counseling, and subsequent prophylaxis.

Fulminant mulch pneumonitis: an emergency presentation of chronic granulomatous disease. Publishing Authors By Initials

S Siddiqui,VL Anderson,DM Hilligoss,M Abinun,TW Kuijpers,H Masur,FG Witebsky,YR Shea,JI Gallin,HL Malech,SM Holland,S Siddiqui,VL Anderson,DM Hilligoss,M Abinun,TW Kuijpers,H Masur,FG Witebsky,YR Shea,JI Gallin,HL Malech,SM Holland,

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Fulminant mulch pneumonitis: an emergency presentation of chronic granulomatous disease. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Intr

Journal: Clinical infectious diseases : an official publica

VOLUME: 45

Page Numbers: 673-81

Journal Abbreviation: Clin. Infect. Dis.

ISSN: 1537-6591

DAY: 8

MONTH: 08

YEAR: 2007

Fulminant mulch pneumonitis: an emergency presentation of chronic granulomatous disease. Information

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LANGUAGE: eng

NlmUniqueID: 9203213

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AFFILIATION: Laboratory of Immune Regulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.

Country: United States

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MEDLINETA: Clin Infect Dis

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