Invasive central nervous system aspergillosis: cure with liposomal amphotericin B, itraconazole, and radical surgery--case report and review of the literature.
Invasive aspergillosis of the central nervous system is a rare but well-described disease. There have been only a few reported survivors, and mortality exceeds 95% in the immunosuppressed host. We present a 2-year-old boy with acute lymphatic leukemia and multiple Aspergillus brain abscesses who was successfully treated with liposomal amphotericin B, itraconazole, and surgical excision of the abscesses. Liposomal amphotericin B is a new preparation that safely allows the attainment of significantly higher tissue levels with less toxicity than standard amphotericin B. The treatment of patients with invasive central nervous system aspergillosis is reviewed.
Coleman
J M
JM
Department of Clinical Microbiology, Royal Children's Hospital, Parkville, Victoria, Australia.
Hogg
G G
GG
Rosenfeld
J V
JV
Waters
K D
KD
D000666:Amphotericin B / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D001232:Aspergillus fumigatus / Q000187:drug effects; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004337:Drug Carriers; D004359:Drug Therapy, Combination; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage*; D008081:Liposomes; D008297:Male; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy
D004337:Drug Carriers; D008081:Liposomes; D017964:Itraconazole; D000666:Amphotericin B