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Invasive aspergillosis — RACP Paediatrics MCQ

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HardIDInvasive aspergillosisRACP Paediatrics

A 12-year-old on high-dose immunosuppression for lupus nephritis develops persistent fever unresponsive to broad-spectrum antibiotics. CT shows pulmonary nodules with a halo sign. Galactomannan antigen is positive. What is the most likely organism and appropriate treatment?

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Correct answer: C — IV amphotericin B

Pulmonary nodules with a halo sign on CT and positive galactomannan in an immunocompromised child are highly suggestive of invasive pulmonary aspergillosis. Voriconazole is the first-line treatment for invasive aspergillosis per ESCMID guidelines. Liposomal amphotericin B is an alternative. Immunosuppression reduction should also be considered.

Reference: Australian Therapeutic Guidelines – 2024 – Antibiotic; RACP Paediatric Curriculum – ID