{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:17:44Z","timestamp":1776338264950,"version":"3.51.2"},"reference-count":14,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Infantile hepatic hemangiomas (IHH) are common benign vascular tumors in infancy with diverse presentations. Methods: We report a 7-week-old infant presenting with hepatosplenomegaly, multiple skin and hepatic hemangiomas, anemia, and recurrent lung infections. Results: Treatment included propranolol, corticosteroids, and sirolimus, along with antifungal prophylaxis with fluconazole. The patient developed pneumothorax and pulmonary aspergillosis. Despite antifungal therapy with voriconazole and liposomal amphotericin B, along with surgical intervention, her condition deteriorated, resulting in multi-organ failure and death at 8.5 months of age. Conclusions: This case illustrates the complexity of IHH management and highlights the risk of severe infections during immunosuppressive therapy even when standard prophylaxis protocols are applied.<\/jats:p>","DOI":"10.3390\/children13040556","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:14:46Z","timestamp":1776334486000},"page":"556","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Aspergillosis in an Infant with Multiple Hepatic Hemangiomas"],"prefix":"10.3390","volume":"13","author":[{"given":"Zuzanna","family":"Karp","sequence":"first","affiliation":[{"name":"Student Scientific Society, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4996-9157","authenticated-orcid":false,"given":"Jakub","family":"Czarny","sequence":"additional","affiliation":[{"name":"Student Scientific Society, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Adamczewska-Wawrzynowicz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznan University of Medical Sciences, 60-572 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4950-2346","authenticated-orcid":false,"given":"Alicja","family":"Bartkowska-\u015aniatkowska","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology and Intensive Therapy, Institute of Pediatrics, Poznan University of Medical Sciences, 60-572 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9412-8931","authenticated-orcid":false,"given":"Katarzyna","family":"Jo\u0144czyk-Potoczna","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology, Institute of Pediatrics, Poznan University of Medical Sciences, 60-572 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7239-4035","authenticated-orcid":false,"given":"Katarzyna","family":"Derwich","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznan University of Medical Sciences, 60-572 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"bcr-2018-224337","DOI":"10.1136\/bcr-2018-224337","article-title":"Rapidly Involuting Congenital Haemangioma of the Liver","volume":"2018","author":"Lewis","year":"2018","journal-title":"BMJ Case Rep."},{"key":"ref_2","unstructured":"Lewis, D., and Vaidya, R. (2025, January 13). Congenital and Infantile Hepatic Hemangioma. [Updated 2023 June 12], StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK518988\/#."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"150970","DOI":"10.1016\/j.sempedsurg.2020.150970","article-title":"Pediatric Hepatic Vascular Tumors","volume":"29","author":"McGuire","year":"2020","journal-title":"Semin. Pediatr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"273","DOI":"10.5409\/wjcp.v5.i3.273","article-title":"History of the Infantile Hepatic Hemangioma: From Imaging to Generating a Differential Diagnosis","volume":"5","author":"Gnarra","year":"2016","journal-title":"World J. Clin. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lucas, B., Ravishankar, S., and Pateva, I. (2021). Pediatric Primary Hepatic Tumors: Diagnostic Considerations. Diagnostics, 11.","DOI":"10.3390\/diagnostics11020333"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.jvsv.2021.03.014","article-title":"Effects of Sirolimus in the Treatment of Unresectable Infantile Hemangioma and Vascular Malformations in Children: A Single-Center Experience","volume":"9","author":"Cho","year":"2021","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e172836","DOI":"10.1172\/JCI172836","article-title":"Infantile Hemangioma: The Common and Enigmatic Vascular Tumor","volume":"134","author":"Holm","year":"2024","journal-title":"J. Clin. Investig."},{"key":"ref_8","unstructured":"(2026, February 25). 10th European Conference on Infections in Leukaemia (ECIL-10). An Update on Primary Antifungal Prophylaxis. 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Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00203-024-04026-z","article-title":"Azole Resistance in Aspergillus Fumigatus- Comprehensive Review","volume":"206","author":"Dladla","year":"2024","journal-title":"Arch. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2018048","DOI":"10.4084\/mjhid.2018.048","article-title":"Invasive Aspergillosis in Children: Update on Current Guidelines","volume":"10","author":"Apsemidou","year":"2018","journal-title":"Mediterr. J. Hematol. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1111\/myc.13643","article-title":"Voriconazole Plasma Concentrations and Dosing in Paediatric Patients below 24 Months of Age","volume":"66","author":"Gastine","year":"2023","journal-title":"Mycoses"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.ijantimicag.2016.11.028","article-title":"Dose Optimisation of Voriconazole with Therapeutic Drug Monitoring in Children: A Single-Centre Experience in China","volume":"49","author":"Liu","year":"2017","journal-title":"Int. J. Antimicrob. 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