PEDIATRICS Vol. 93 No. 5 May 1994, pp. 830-835
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Successful Medical Therapy of Aspergillus Osteomyelitis of the Spine in an 11-Year-Old Boy With Chronic Granulomatous Disease

Mark W. Kline MD1, Mary E. Paul MD1, Howard M. Rosenblatt MD1, William T. Shearer MD, PhD1, and Florante C. Bocobo MD2

1 Dept of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX
2 Bristol-Myers Squibb Company, Inc, The Liposome Company, Inc, Princeton, NJ

Aspergillus is one of the most common causes of serious infection and death in individuals with chronic granulomatous disease (CGD).1 Clinically evident infection often begins in the lung with pneumonia; contiguous spread or dissemination of infection may occur. Vertebral osteomyelitis in individuals with CGD usually is caused by Aspergillus.2 Unfortunately, despite aggressive medical and surgical therapy of this condition, reported cases have been associated with treatment failure, recurrence, severe disabling orthopedic or neurologic complications and death.2-5

In this report we describe a unique case in which therapy with intravenous amphotericin B lipid complex (AmBLC), oral itraconazole, and granulocyte transfusions resulted in complete clinical and radiographic resolution of Aspergillus fumigatus osteomyelitis of the spine.

Submitted on July 21, 1993
Accepted on October 25, 1993


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