{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:06:21Z","timestamp":1773849981910,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":197,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2025,1]]},"abstract":"\n This case illustrates the susceptibility of pediatric patients with chronic lung disease, here, a 3\u2010year\u2010old male with structural airway injury and impaired mucociliary clearance from recurrent aspiration (due to Chiari II malformation and spinal dysgenesis), to life\u2010threatening polymicrobial co\u2010infections, even without classic immunodeficiency. The child was admitted with acute respiratory failure and sepsis; imaging demonstrated necrotizing pneumonia and pneumatoceles; bronchoalveolar lavage confirmed \u2217\n Aspergillus<\/jats:italic>\n \u2217 galactomannan positivity and \u2217\n Nocardia<\/jats:italic>\n \u2217 species, warranting broad antimicrobial therapy and mechanical ventilation. Diagnosis of invasive aspergillosis and treatment initiation were delayed; despite therapy, he developed multiorgan failure and died. This highlights how chronic lung disease predisposes children to catastrophic fungal\u2013bacterial synergies and reinforces the value of early bronchoscopy for targeted treatment. Advanced disease with structural damage portends poor outcomes, underscoring the need for enhanced surveillance in this high\u2010risk cohort.\n <\/jats:p>","DOI":"10.1155\/crpe\/6659641","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T17:33:49Z","timestamp":1752773629000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Invasive Pulmonary Aspergillosis and Nocardia Pneumonia in a Pediatric Patient With Chronic Lung Disease: A Case Report"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2377-2789","authenticated-orcid":false,"given":"Ahmed H.","family":"Ali","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4000-1407","authenticated-orcid":false,"given":"Mahmoud","family":"Kamal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6498-1946","authenticated-orcid":false,"given":"Mohammed E.","family":"Elyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2005.01143.x"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00002211"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01102-06"},{"key":"e_1_2_9_4_2","unstructured":"PoovazhagiV. 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