title: Successful treatment of multiple Pseudallescheria boydii brain abscesses and ventriculitis/ependymitis in a 2-year-old child after a near-drowning episode.
abstract: BACKGROUND
  We report on a cerebral infection by Pseudallescheria boydii in a 21-month-old boy after a near-drowning episode. MRI revealed multiple (> 60) intracerebral abscesses.
  
  
  METHODS
  The surgical therapy included CSF drainage and microsurgical resection of one abscess for microbiological diagnosis. Antimycotic therapy included terbinafine and intraventricular caspofungin in addition to voriconazole.
  
  
  RESULTS
  Systemic side effects of chemotherapy were not observed. After placement of a ventriculoperitoneal shunt, the boy was transferred to a rehabilitation clinic and improved neurologically. After 20 months, MRI documented a continuing remission of the disease.
  
  
  CONCLUSIONS
  Our case proves that an aggressive treatment should be undertaken and can be successful in CNS pseudallescheriasis.
authors.affiliation: Department of Neurosurgery, Zentralklinik, Robert-Koch Allee 9, 99438, Bad Berka, Germany.
authors.forename: Kay
authors.initials: K
authors.lastname: Mursch
authors.forename: Svorad
authors.initials: S
authors.lastname: Trnovec
authors.forename: Heinrich
authors.initials: H
authors.lastname: Ratz
authors.forename: Detlef
authors.initials: D
authors.lastname: Hammer
authors.forename: Regine
authors.initials: R
authors.lastname: Horré
authors.forename: Albrecht
authors.initials: A
authors.lastname: Klinghammer
authors.forename: Sybren
authors.initials: S
authors.lastname: de Hoog
authors.forename: Julianne
authors.initials: J
authors.lastname: Behnke-Mursch
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000150:complications / Q000382:microbiology / Q000628:therapy*; D004679:Encephalomyelitis / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008271:Mycetoma / Q000209:etiology*; D015701:Near Drowning; D009493:Neurosurgery / Q000379:methods; D011541:Pseudallescheria
chemical_list: D000900:Anti-Bacterial Agents