J Korean Pediatr Soc.  2000 Aug;43(8):1116-1121.

A Case of Primary Multiple Intracerebral spergillosis Abscess in Neonate:Treatment with Amphotericin B, Flucytosine and Itraconazole

• Oh BL
• Lee OK
• Kim YS
• Kim YS

Abstract

Fungal infection of the central nervous system tends to occur mostly in immunosuppressed patients. In the pediatric population, it is usually seen in severely immunocompromised patients, particulary in children with chronic granulomatous disease and hematopoietic malignancies. Although aspergillosis is considered one of the most frequent agents of mycotic infection of the brain, it is especially rare in the neonatal period, and overwhelming multisystem infection is usually diagnosed postmortem. Manifestations include meningitis, meningoencephalitis, granulomata formation, brain abscess, vasculitis, aneurysm formation, infarct and intracranial hemorrhage. We present a neonate who had brain abscess diagnosed by MRI, and aspergillus was found at surgical exploration. There are very few reported survivors of neonatal aspergillosis. We reported a case of primary multiple brain abscess caused by aspergillus associated with severe hypernatremic dehydration and prerenal azotemia. The patient was treated with amphotericin B combined with flucytosine and itraconazole.

Keyword

Brain abscess; Aspergillus; Amphotericin B; Flucytosine; Itraconazole

MeSH Terms

Abscess*
Amphotericin B*
Aneurysm
Aspergillosis
Aspergillus
Azotemia
Brain
Brain Abscess
Central Nervous System
Child
Dehydration
Flucytosine*
Granulomatous Disease, Chronic
Hematologic Neoplasms
Humans
Immunocompromised Host
Infant, Newborn
Intracranial Hemorrhages
Itraconazole*
Magnetic Resonance Imaging
Meningitis
Meningoencephalitis
Survivors
Vasculitis
Amphotericin B
Flucytosine
Itraconazole