[Invasive aspergillosis. Description of a case in an infant with severe granulocytopenia and endocardial fibroelastosis].
Invasive Aspergillosis in a child with severe granulocitopenia and endocardial fibroelastosis. A case of invasive aspergillosis in a 3-month old baby is reported. At autopsy gross examination revealed the presence of whitish nodules in the liver, spleen, kidneys and suprarenal glands. A black eschar with surrounding erythema involved the left auricle. The heart showed dilated left ventricle with porcelain-like thickening of the endocardium. The histological section of the hepatic nodular lesions showed Aspergillus colonization, vascular invasion with hyphal forms and necrotic granulomatous lesions in the other sites. Histologically, the endocardium is markedly thickened and rich in connective tissue and elastic fibres. Examination of the bone-marrow showed poor cellularity with a striking reduction of cells of the neutrophil granulocyte series. Aspergillosis may complicate the course of the child in immunocompromised state. Granulocitopenia causes an insufficient delimitation of infections and allows metastatic diffusion of fungi, through blood-vessels invasion.