Invasive aspergillosis in a child without any identifiable risk factors

The diagnosis of invasive aspergillosis is difficult because its clinical presentation overlaps with other common diseases. This disease is rare in children without any risk factors. We share a case of a healthy young Asian boy who presented with persistent fever, generalized lymphadenopathy, and pericardial effusion. Given these symptoms, the initial suspicion leaned heavily towards tuberculosis (TB) or lymphoma. On further investigations, the unexpected diagnosis was made as his lymph node culture grew Aspergillus flavus. This case serves as an important reminder that invasive aspergillosis, although rare in children without traditional risk factors, can still present in the most surprising ways.