Recurrent invasive pulmonary aspergillosis or breakthrough fungal infection in a child after haploidentical hematopoietic stem cell transplantation

Invasive fungal infections (IFI) are devastating and life-threatening infections affecting especially immunocompromised patients. We report on a case of a 14-year-old boy with myelodysplastic syndrome (MDS), after haploidentical hematopoietic stem cell transplantation, in whom invasive pulmonary aspergillosis (IA) was diagnosed and successfully treated with subsequent (despite the secondary antifungal prophylaxis) IA or breakthrough infection development. Thanks to intensive and broad spectrum antifungal treatment (voriconazole upfront therapy, followed by a combination of voriconazole and micafungin, and eventually by the amphotericin B lipid complex), significant improvement was accomplished.