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) along with methylprednisolone pulses. She developed bilateral amaurosis, febrile pancytopenia, recurrent pneumonia, urinary infection and sepsis. During her last hospitalization, she presented respiratory distress with severe dyspnea. She was treated with prednisone, voriconazole, sulfamethoxazole-trimethoprim, vancomycin, metronidazole, ciprofloxacin, meropenem and amphotericin B over the course of 50 days in hospital, with intermittent recoveries. During an episode of worsened dyspnea, she presented shock and was admitted to the intensive Care Unit. High-resolution computed tomography on the chest showed bronchiectasis and thickening of the intra and interlobular interstices, together with ground-glass opacity and randomly distributed nodules, which suggested acute respiratory distress syndrome associated with fibrosis (

revista da sociedade brasileira de medicina tropical

Severe cytomegalic pneumonitis associated with pulmonary aspergillosis in a child with immunosuppression due to chemotherapy for treating pineoblastoma