Successful treatment of a child with vascular pythiosis

BMC Infectious Diseases

Case Report

Tavitiya Sudjaritruk¹  Virat Sirisanthana² 

[1] Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand;Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand;Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand;

关键词: Computerize Tomography Angiography;    Terbinafine;    Paroxysmal Nocturnal Hemoglobinuria;    Intermittent Claudication;    External Iliac Artery;   

DOI  :  10.1186/1471-2334-11-33

 received in 2010-09-03, accepted in 2011-01-29,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundHuman pythiosis is an emerging and life-threatening infectious disease caused by Pythium insidiosum. It occurs primarily in tropical, subtropical and temperate areas of the world, including Thailand. The aim of this report is to present the first pediatric case of typical vascular pythiosis.Case PresentationA 10-year-old boy with underlying β-thalassemia presented with gangrenous ulcers and claudication of the right leg which were unresponsive to antibiotic therapy for 6 weeks. Computerized tomography angiography indicated chronic arterial occlusion involving the right distal external iliac artery and its branches. High-above-knee amputation was urgently done to remove infected arteries and tissues, and to stop disease progression. Antibody to P. insidiosum was detected in a serum sample by the immunoblot and the immunochromatography tests. Fungal culture followed by nucleic sequence analysis was positive for P. insidiosum in the resected iliac arterial tissue. Immunotherapeutic vaccine and antifungal agents were administered. The patient remained well and was discharged after 2 months hospitalization without recurrence of the disease. At the time of this communication he has been symptom-free for 2 years.ConclusionsThe child presented with the classical manifestations of vascular pythiosis as seen in adult cases. However, because pediatricians were unfamiliar with the disease, diagnosis and surgical treatment were delayed. Both early diagnosis and appropriate surgical and medical treatments are crucial for good prognosis.

【 授权许可】

CC BY   
© Sudjaritruk and Sirisanthana; licensee BioMed Central Ltd. 2011