Diagnostic Mimicry: Invasive Aspergillosis Masquerading as Pulmonary Tuberculosis in a Patient with Chronic Granulomatous Disease

Zakertavalaee, Fatemeh; Aelami, Mohammad Hassan; Badiee, Fatemeh; Riazi, Hedieh

doi:10.22038/jpp.2026.96488.5681

Diagnostic Mimicry: Invasive Aspergillosis Masquerading as Pulmonary Tuberculosis in a Patient with Chronic Granulomatous Disease

Articles in Press

Document Type : case report

Authors

fatemeh zakertavalaee

Mohammad Hassan aelami

fatemeh badiee

Hedieh riazi

Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/jpp.2026.96488.5681

Abstract

Abstract:

A 4.5-year-old boy was admitted to the hospital with a history of three weeks of fever, cough, and weight

loss. He was initially started on empiric treatment for community-acquired pneumonia. Suspicion of

tuberculosis led to the addition of anti-tuberculosis therapy. However, his condition further deteriorated,

warranting the persistence of investigations. Chronic granulomatous disease (CGD) and pulmonary

aspergillosis were confirmed in the patient by various laboratory tests. He responded quite well to a

combination antifungal therapy including liposomal amphotericin B and voriconazole. This case

emphasizes that CGD should be considered in patients with recurrent infections caused by opportunistic

pathogens.

Keywords

Chronic Granulomatous Disease

Invasive aspergillosis

Pediatric Immunodeficiency

NADPH Oxidase