NEONATAL PULMONARY ASPERGILLOSIS AS THE F IRST MANIFESTATION OF CHRONIC GRANULOMATOUS-DISEASE

Background. - Pulmonary aspergillosis is now the main cause of death i n chronic granulomatous disease (CGD); it may occur before the age of one year and then often reveals CGD. Case report. - A male newborn was referred to hospital at 27 days of age for fever (39 degrees C), hemo dynamic failure and biological inflammation syndrome caused by pulmona ry infection. Chest CT scan revealed multiple and bilateral intraparen chymatous nodules. An open lung biopsy showed histiocystic granuloma w ith multinucleated giant cells. Culture of tracheal, bronchoalveolar l avage samples and lung biopsy grew positive for Aspergillus fumigatus. Impaired chemiluminescence production by neutrophils was detected, en abling the diagnosis of CGD. It was later confirmed by the study of ne utrophils functions. The child recovered after 12 months of parenteral amphotericin B therapy. Conclusion. - A febrile multifocal pneumopath y occurring in infancy should lead to consider the possibility of CGD which may be confirmed by the chemiluminescence test.